ReviewThe archives of bone and joint surgery2021
Open Pilon Fracture Postoperative Outcomes with Definitive Surgical Management Options: A Systematic Review and Meta-analysis.
Review in The archives of bone and joint surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 19 citations in OpenAlex.
- Comparison of two-stage open reduction and internal fixation and single-stage external fixation for complex pilon fractures: a randomized controlled trial.International orthopaedics · 2026Trial
- Biomechanical and Viscoelastic Properties of the Ankle Muscles in Relation to Muscle Force in Patients with Operated Tibial Pilon Fractures.Journal of clinical medicine · 2026Article
- Topical antibiotic therapy to reduce infection after operative treatment of fractures at high risk of infection: TOBRA-a multicenter randomized controlled trial protocol.OTA international : the open access journal of orthopaedic trauma · 2026Article
- Tibiotalar Nailing for Geriatric Pilon Fractures: Case Report and Review of the Literature.Journal of orthopaedic case reports · 2025Article
- Orthoplastic Reconstruction of Distal Tibia High-Energy Fractures Using a Circular External Fixator-A Systematic Review.Journal of clinical medicine · 2024Review
- Fracture blisters: predictors for time to definitive fixation in pilon fractures.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024Article
- Development and validation of a nomogram for predicting the risk of postoperative fracture blister after pilon fracture.Frontiers in surgery · 2024Article
- Treatment strategies for complex ankle fractures-current developments summarized in a narrative review.Annals of translational medicine · 2023Review
- Article
- Development of a nomogram to predict surgical site infection after open reduction and internal fixation for closed pilon fracture: a prospective single-center study.Journal of orthopaedic surgery and research · 2023Article
- Ankle joint salvage and reconstruction by limited ORIF combined with an Ilizarov external fixator for complex open tibial pilon fractures (AO 43-C3.3) with segmental bone defects.BMC musculoskeletal disorders · 2022Article
- Open Pilon Fracture Postoperative Outcomes with Definitive Surgical Management Options: A Systematic Review and Meta-analysis.The archives of bone and joint surgery · 2021Review
- Management of Pilon Fractures-Current Concepts.Frontiers in surgery · 2021Review
- Treatment of pilon fractures with low profile plates.International journal of burns and trauma · 2021Article
- Outcomes of Acute Ankle Distraction for Intra-articular Distal Tibial and Pilon Fractures.Strategies in trauma and limb reconstructionReview
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPilon fractures represent one of the most surgically challenging fractures in orthopaedics. Different techniques exist for their management, with open reduction and internal fixation (ORIF) and External fixation (Ex-Fix) the most widely used. Whilst there is a plethora of data regarding these strategies for Pilon fractures as a whole, very limited data exists solely on the management of
methodsWe conducted a search in PubMed, EMBASE and CENTRAL for postoperative complications and functional outcomes in open pilon fractures in those treated with Ex-Fix vs ORIF (PROSPERO-CRD42020184213). The postoperative complications measured included non-union, mal-union, delayed union, bone grafting, amputation, osteoarthritis, deep infection and superficial infection. Functional outcomes in the form of the AOFAS score was also measured where possible. We were able to carry out a meta-analysis for both deep infections and non-unions.
resultsThe search yielded 309 results and a total of 18 studies consisting of 484 patients were included. All fractures included were open, and consisted of 64 Gustilo-Anderson Type I, 148 Type II, 103 Type IIIa, 90 Type IIIb and 9 Type IIIc. 60 Type III fractures could not be further separated and 12 were ungraded. Both ORIF and Ex-Fix were found to have statistically similar AOFAS scores (
conclusionBased on our study, while Ex-Fix and ORIF have similar functional outcomes, Ex-Fix appears to have a significantly higher risk of postoperative complications which must be considered by surgeons when choosing surgical management options. Further research, ideally in a randomised control trial format, is required to definitively demonstrate ORIF superiority in the management of open pilon fractures.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.