ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2020
Strategies to minimize soft tissues and septic complications in staged management of high-energy proximal tibia fractures.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Long-term results of staged management of complex lisfranc and chopart injury: a retrospective cohort study and systematic literature review.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Pooled it
- Current concepts in the management of high-energy tibial plateau fractures: a narrative review.EFORT open reviews · 2026Review
- Clinical outcomes following open reduction and internal fixation without primary cruciate ligament reconstruction or avulsion fixation for Schatzker types IV-VI tibial plateau fractures: a retrospective cohort study.BMC musculoskeletal disorders · 2026Article
- Role of Hybrid Fixator in Proximal Tibial Fractures: A Prospective Evaluation of Clinical and Radiological Outcomes.Cureus · 2026Article
- Surgical wound complications in ankle ORIF patients: a predictive analysis on a single-center retrospective cohort of 287 patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Article
- Five decades of total ankle replacement: from early failures to fourth-generation innovations and future priorities.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Review
- Article
- Staged treatment of bicondylar tibial plateau fractures: influence of frame configuration and quality of reduction on outcomes.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Establishing regions of interest of the lower leg and ankle for perioperative volumetric assessment with a portable 3D scanner in orthopedic and trauma surgery - a pilot study.Journal of foot and ankle research · 2023Article
- External fixator pin placement during initial management of tibial plateau fractures: are there parameters to minimize pin-plate overlap?European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023Article
- Application of Adjustable Skin Stretchers in Repairing Wound-Related Defects.Clinical, cosmetic and investigational dermatology · 2023Article
- A comparison of clinical, radiological, and quality-of-life outcomes of double-plate internal and Ilizarov external fixations for Schatzker type 5 and 6 tibia plateau fractures.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Utilizing the various forms of the gastrocnemius muscle in fix & flap protocol: a reliable remedy for open proximal tibial fractures with accompanying soft tissue defect.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2022Article
- Staged surgery for closed Lisfranc injury with dislocation.Frontiers in surgery · 2022Article
- Article
- Comparison Between the Modified External Fixation and Calcaneal Traction in Ruedi-Allgower Type II/III Pilon Fractures.Medical science monitor : international medical journal of experimental and clinical research · 2021Article
- Early complications of preoperative external traction fixation in the staged treatment of tibial fractures: A series of 402 cases.World journal of clinical cases · 2020Article
Corrections and comments
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSoft tissues (wound dehiscence, skin necrosis) and septic (wound infection, osteomyelitis) complications have been historically recognized as the most frequent complications in surgical treatment of high-energy proximal tibia fractures (PTFs). Staged management with a temporary external fixator is a commonly accepted strategy to prevent these complications. Nonetheless, there is a lack of evidence about when and how definitive external or internal definitive fixation should be chosen, and which variables are more relevant in determining soft tissues and septic complications risk. The aim of the present study is to retrospectively evaluate at midterm follow-up the results of a staged management protocol applied in a single trauma center for selective PTFs.
methodsThe study population included 24 cases of high-energy PTFs treated with spanning external fixation followed by delayed internal fixation. Severity of soft tissues damage and fracture type, timing of definitive treatment, clinical (ROM, knee stability, WOMAC and IOWA scores) and radiographic results as well as complications were recorded. RESULTS AND
conclusionComplex fracture patterns were prevalent (AO C3 58.3%, Schatzker V-VI 79.1%), with severe soft tissues damage in 50% of cases. Mean time to definitive internal fixation was 6 days, with double-plate fixation mostly chosen. Clinical results were highly satisfying, with mean WOMAC and IOWA scores as 21.3 and 82.5, respectively. Soft tissue complication incidence was very low, with a single case of wound superficial infection (4.3%) and no cases (0%) of deep infection, skin necrosis or osteomyelitis. Staged management of high-energy PTFs leads to satisfying clinical and radiographic results with few complications in selected patients.
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