• Users Online: 285
  • Print this page
  • Email this page
ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 4  |  Page : 334-341

The influence of initial cartilage damages in pilon fractures on the development of osteoarthritis and functional outcomes: A prospective multicentre case series


1 Department of Surgery, Canton's Hospital Graubuenden, Switzerland
2 AO Clinical Investigation and Documentation, Canton's Hospital Baselland, Switzerland
3 Department of Orthopaedics and Traumatology, Canton's Hospital Baselland, Switzerland

Correspondence Address:
Dr. Christoph Sommer
Department of Surgery, Kantonsspital Graubuenden, Loestrasse 170, 7000 Chur
Switzerland
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jmsr.jmsr_60_19

Rights and Permissions

Objectives: Pilon fractures have a long-term negative impact on patients. Both initial cartilage damages (CDs) and osteoarthritis (OA) have been suggested to influence outcomes, but direct clinical evidence has been lacking. This study aims to investigate the association of initial CDs, OA occurrence, and functional outcomes. Methods: This is a prospective multicentre observational case series with a 2-year follow-up (FU). Initial CDs were evaluated intraoperatively in 116 enrolled patients; the postoperative OA was evaluated using FU radiographs. Functional outcomes were assessed using the Foot and Ankle Ability Measure (FAAM) for the activity of daily living (ADL) and sports activities (Sports). Change of FAAM scores over time was analyzed using mixed-effects model. Results: The 2-year loss-to-FU rate was 44.0%. Initial CDs on weight-bearing talus were statistically significantly associated with OA development (1-year, P < 0.001 and 2-year, P= 0.018) and poor functional outcomes (2-year ADL, P= 0.012 and 2-year Sports, P= 0.001). The existence of OA was statistically significantly associated with lower 1-year ADL scores (P = 0.018), 1-year Sports scores (P = 0.023), and 2-year Sports scores (P = 0.023). Patients with “good” reduction had higher outcome scores compared to patients with “satisfactory” reduction. Conclusions: In patients with well-reduced pilon fractures, initial CDs were associated with early/mid-term OA development and worse functional outcomes. OA occurrence was associated with worse functional outcomes. Current results need confirmation with a larger cohort.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed270    
    Printed36    
    Emailed0    
    PDF Downloaded57    
    Comments [Add]    

Recommend this journal