Pilon fractures in the distal tibia result from axial forces that can range from low to high energy and produce a spectrum of articular and metaphyseal injuries. All study group patients already started warm up exercises, gentle ROM exercises of the knee joint on the second to the fifth postoperative day. Physical therapy is an integral part of full recovery. Patients: Two hundred twenty-five of 480 eligible patients completed the survey (response rate 47%). Perioperative complications may occur preoperatively, intraoperatively, or postoperatively. Pilon fractures often result from high-energy trauma such as a car or motorcycle accident, fall from height, or skiing accident or low energy force. Patients were included if they were using the IDEO after sustaining a surgically treated pilon fracture and had exhausted all nonoperative therapies. Cheers, Aravind. Frequently, with this type of fracture the fibula is broken as well. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. The highest percent in both groups had Pilon fracture associated with other skeletal injuries (60.0%, & 70.0% respectively). This could be due to the effect of the rehabilitation exercises program which study group followed it where improved blood supply to the injured site & helped in normal fracture healing process. Tool III: Rehabilitation Exercises Program for Pilon Fracture, This tool was developed by the researchers after reviewing current national and international literatures. Pilon Fracture Rehabilitation Exercises Program Outcome. These impairments can make performing your normal everyday activities difficult or impossible. If you have fractured your leg, your physical therapist can help you improve walking and help decide if you should walk with a walker, crutches, quad cane, or standard cane. These can be challenging to manage, especially when associated with significant soft-tissue injury. Patients’ recruitment started in January 2017 and final data collection procedure was performed in January 2018. - toe crunches. All Patients were interviewed and assessed two times. Surgical treatment of pilon fracture based on ankle position at the time of injury/initial direction of fracture displacement: a prospective cohort study. (Eds. With this type of injury, the other bone in the lower leg, the fibula, is frequently broken as well 4. Table 2. Puthoff, ML, and Nielsen, DH: Relationships among impairments in lower extremity strength and power. 2007 Jul. The term "pilon" comes from the French word for pestle. A Pilon fracture is a severe injury involving the ankle joint. Pilon fractures are relatively rare, especially in children and elderly people. Full recovery (return to all activities) typically takes 3-6 months. It consisted of fifteen open ended questions. Seven patients meeting these criteria were identified. Infection, which may need treatment with antibiotics or follow-up surgery The lower ends of these bones make up part of the ankle. "Pilon Fracture Rehabilitation Exercises Program Outcome.". Also the current study showed a marked improvement in the study group patients’ Mazur ankle score at 6th months follow up than control group patients which was apparent in decreased pain, swelling, better range of motion, and improved gait. Each session taked about 45 minutes. With pilon fractures, there can be total cartilage death after 6 months. Barei, D.: Pilon fractures. What causes a pilon fracture of the ankle? This specific type of fracture is uncommon. Frequently, with this type of fracture the fibula is broken as well. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation. Pilon fractures often involving a lengthy, sometimes painful recovery time. �����-)�#�X�p!�r��/���+Ȧ�J��$�9�v�$��}�N�=��;Q. Open fractures or fractures in patients with multiple injuries were stabilized with traveling traction that was applied in the operating room. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. The goal of surgery is to put the bones back into the position that they were in prior to the injury. ADULT ANKLE FRACTURES B y: Robert H. Sheinberg, D.P.M., D.A.B.F.A.S., F.A.C.F.A.S. Setting; the study was conducted in Traumatology Department of Assuit University Hospital. )�w˗/$�s� �E$#'�'��K$V{�S��*�W^���B��-����� ����/�������� �F(� �(!��B��8r\��t�_�Ku!����ҿ��ݓ�0��.�"+�m�˲of����O�3q[��)ܝ�4���c^�ŗ^V��z:��#��#�d���'�u���NBQ���� &��X��WN�^\��>�����D���/n>�WG�۲����5r[���k�� Written informed consent was obtained from patients included in the study. Pilon fractures are injuries that occur at the lower end of the tibia and involve the weight bearing surface of the ankle joint. Table 4 presents a marked reduction in the complications rate among the study group patients who received the rehabilitation exercise program than the control group patients, where 90% of the study group patients didn’t develop early complications nor late complications while 70% of the control group patients who didn’t develop early complications and only 36.7% who didn’t develop late complications. Pilon Fracture; Shown below is a pre-operative and post-operative picture of a bimalleolar ankle fracture of a 72-year-old female who fell in her home. To evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. Your ankle will not be like it was before your injury. to you about your symptoms and about your medical history. - toe crunches. The majority of the time, pilon fractures are severe enough with displaced fracture fragments involving the ankle joint that they require surgical intervention. Early complications as wound complications can lead to deep infection with potentially catastrophic consequences. Mazur JM, Schwartz E, Simon SR. Ankle arthrodesis: Long-term follow-up with gait analysis. Recommendation: Rehabilitation exercises program for Pilon fracture should be carried out on an individual basis from beginning of this fracture to prevent postoperative complications and achieve better outcome. The motion of the talus acting like a hammer or pestle as it crashes into the tibial plafond. Table 5 clarifies that no statistically significant difference at the time of admission was found between the two groups (study & control) regarding their level of knowledge about the rehabilitation exercises program for pilon fracture. Pilon fractures have a 2 stage procedure for treatment. The ankle joint is formed by the tibial plafond superiorly, the talus inferiorly and malleoli medially, laterally, and posteriorly 3. This study finding was in a line with a study conducted by Jiang et al. A broken ankle can severely limit your ability to perform basic functional tasks like running and walking. Most of patients in both study &control groups treated by two staged protocol where external fixator applied for a period ranged from two to three weeks then the second stage “ open reduction & internal fixation” was done. There was obvious improvement among the study group who applied the rehabilitation exercise program compared with the control group, where majority of the study group patients their duration of immobilization and the starting time for weight bearing were six weeks (80% & 86.7% respectively), while about half of the control group patients their duration of immobilization was more than six weeks and the starting time for weight bearing was more than twelve weeks. These are typically lower-energy injuries to the tibia and fibula at the ankle joint. Setting: Two level 1 trauma centers. Intervention: Open reduction internal fixation for tibial pilon fracture. So the complication rate was fewer among this group than those who didn’t apply the rehabilitation exercises program. Research hypothesis; the outcome of study group patients will be better than the outcome of control group. The fracture involves the larger bone of the lower leg (tibia), and extends into the weight bearing surface of the ankle joint. High velocity trauma is often associated with intra-articular comminution, multiple metaphyseal fragments and soft tissue injuries, making their management challenging 5. Date entry and data analysis were done using SPSS version 19 (Statistical Package for Social Science). Pilon fractures are often high-impact injuries that may result in the destruction of bones at the ankle joint. Adam, Faisal Fahmy, Amna Abdullah Desouky, and Esmat Sayed Abd-Elmeegeed. The study was conducted in Traumatology Department and follow up was conducted in the Orthopedic Outpatient Clinics, Assuit University Hospital- Eygpt. <> Patients: Two hundred twenty-five of 480 eligible patients completed the survey (response rate 47%). That is kept on for 2-5 weeks until the soft tissue is in better condition. Considering all these facts; this study was conceived and designed so to evaluate the outcome of rehabilitation exercises program on Pilon fracture. Design: Retrospective cohort study with follow-up by questionnaire. Possible complications of pilon fracture of the ankle. High-energy impacts most commonly cause pilon fractures. 3 0 obj Research hypothesis; the outcome of study group patients will be better than the outcome of control group.

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