Indications Follow up – Pilon Fracture – Soft Tissue Management 6/6/23




View this email in your browserWEEKLY FOLLOW UP!   Thank you to all who joined us for our webinar last week where we covered Pilon (Pea-lon) fractures.  

We hit so many key points.  In case you missed the webinar, click here to access the recordings!

Remember the 4 tenants.

1) Anatomic reduction and fixation of associated fibular fracture
2) Anatomic restoration of the articular surface
3) Bone grafting of metaphyseal defects including use of allograft, autograft and bone graft substitutes.
4) Fragment specific fixation plating to allow early motion. (ie. mini frag plating)These injuries are more than just bone.  

These are high energy injuries with a tenuous soft tissue envelope.  Minimizing complications include careful handling of the soft tissue.  As Jan Szatkowski said, “The issue is the tissue”

Keys for Infection Prevention Include….
1) Thorough and meticulous irrigation and debridement (1)
2) Close traumatic wounds early if possible
3) Early administration of IV antibiotics. Consider use of intramedullary synthetic bone graft with antibiotics – Calcium sulfate or phosphate(2)
4) Tension Free Early Closure if possible
5) Judicious use of negative pressure wound dressings
6) Provisional External Fixation for stability and soft tissue rest

Looking forward to next month where we will cover Talus Fractures.  Dates TBD.
Feel free to forward to friends and colleagues!

(1)Rupp M, Popp D, Alt V. Prevention of infection in open fractures: Where are the pendulums now? Injury. 2020 May;51 Suppl 2:S57-S63. doi: 10.1016/j.injury.2019.10.074. Epub 2019 Oct 25. PMID: 31679836.(2)Aljawadi A, Naylor T, Islam A, et al. (January 05, 2022) Radiological Analysis of Gentamicin Eluting Synthetic Bone Graft Substitute Used in the Management of Patients With Traumatic Bone Voids. Cureus 14(1): e20969. doi:10.7759/cureus.20969

Click here to join our newsletter! LogoCopyright (C) 2023 STRASSER ORTHOPEDIC SERVICESAll rights reserved.“Indications” is a medical education series for medical technology consultants in orthopedics. We focus on a case based approach to learning the principals of orthopedic surgery geared for the medical sales rep.

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