TITLE:
Advantages of Ilizarov External Fixation in an Elderly Patient with Pilon Fracture with Severe Soft Tissue Injury and Severe Osteoporosis: A Case Report
AUTHORS:
Koji Nozaka, Naohisa Miyakoshi, Hidetomo Saito, Shuichi Chida, Hiroyuki Tsuchie, Yusuke Yuasa, Motoki Mita, Yoichi Shimada
KEYWORDS:
Ilizarov External Fixation, Elderly Patient, Pilon Fracture, Soft Tissue Injury, Osteoporosis
JOURNAL NAME:
Open Journal of Orthopedics,
Vol.9 No.1,
January
28,
2019
ABSTRACT: Introduction: Pilon fracture in elderly individuals is characterized by senile skin atrophy, poor dermal extensibility, and thin subcutaneous tissue. The use of bulky internal fixation material can thus cause the swelling that accompanies the fracture to induce secondary injury to skin tissue. In addition, initiation of postoperative weight-bearing is delayed due to bone fragility and difficulties with partial weight-bearing, causing a tendency toward prolonged hospitalization. Mean duration of hospitalization after pilon fracture for elderly patients in our department was 79.2 days. Case Presentation: An 80-year-old woman with pilon fracture with soft tissue injury and severe osteoporosis was transferred to our department. The fracture was treated using Ilizarov external fixation. Fourteen days postoperatively, walking with full weight-bearing was permitted. The hospital stay was 28 days. The external fixator of the ankle was removed 87 days postoperatively, at which time the patient was anatomically and functionally recovered and able to walk unaided. Conclusion: Ilizarov external fixation may represent a useful option in elderly patients with pilon fracture showing severe soft tissue injury and severe osteoporosis. The present case provides evidence that this procdure can be successfully applied to the management of such pilon fractures in elderly patients.