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Author: search.filters.author.Cristian OrtizSubject: search.filters.subject.fracture

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    Early Weight-Bearing After Percutaneous Reduction and Screw Fixation for Low-Energy Lisfranc Injury
    (2013)
    WAGNER HITSCHFFELD, EMILIO  
    ;
    Cristian Ortiz
    ;
    Ignacio E. Villalón
    ;
    Andrés Keller
    ;
    Pablo Wagner  
    <jats:sec><jats:title>Background:</jats:title><jats:p>Anatomic restoration and postoperative rehabilitation of displaced fracture-dislocations of the tarsometatarsal junction of the foot are essential. Our objective was to report percutaneous reduction and screw fixation results in low-energy Lisfranc fracture dislocation injuries that were treated with early weight-bearing and rehabilitation.</jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p>We retrospectively evaluated patients with low-energy Lisfranc injuries who underwent surgery between May 2007 and April 2011. The study reviewed 22 patients (12 men and 10 women) with an average age of 36.2 years (range, 16-50 years) and an average follow-up of 33.2 months (range, 12-50 months). We report the mechanism of trauma; quality of reduction in the postoperative digital radiographs; subjective satisfaction; AOFAS score; time required to return to work, recreational activities, and low-impact sports; and complications. Postoperatively, all of the patients were instructed to be non-weight-bearing for 3 weeks, and the stitches were removed after 2 weeks. At the third postoperative week, the patients were encouraged to bear weight as tolerated.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Quality of reduction was anatomic or near anatomic in 100% of cases. The subjective satisfaction reported by patients was very good, with complete satisfaction in 20 of them (90.9%). The AOFAS average was 94 points (range, 90-100 points). Average return to work was at 7 weeks (range, 6-9 weeks), recreational activities 7.2 weeks (range, 6-9 weeks), training for low-impact sports 7.6 weeks (range, 7-8 weeks), and symptom-free sport activities 12.4 weeks (range, 11-13 weeks).</jats:p></jats:sec><jats:sec><jats:title>Conclusion:</jats:title><jats:p>In this selected group of patients with low-energy Lisfranc fracture dislocation, anatomic or near-anatomic reduction can be achieved with percutaneous reduction and screw fixation. Early weight-bearing is possible in these patients, and early return to regular activities and low-impact sport can be expected.</jats:p></jats:sec><jats:sec><jats:title>Level of Evidence:</jats:title><jats:p>Level IV, retrospective case series.</jats:p></jats:sec>
      5Scopus© Citations 47
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    SOFT-TISSUE INJURY TO THE FOOT AND ANKLE: LITERATURE REVIEW AND STAGED MANAGEMENT PROTOCOL
    (2019)
    Alexandre Leme Godoy-Santos
    ;
    Tim Schepers
    ;
    Cristian Ortiz
    <jats:p>ABSTRACT Complex trauma of the foot and ankle is characterized by fractures with severe soft tissue damage associated with neurovascular injury and joint involvement. These injuries are frequently present in the polytraumatized patient and are a predictor of unfavorable clinical outcome. In the initial approach to a patient with complex foot and ankle trauma, the decision between amputation and reconstruction is crucial. The various existing classification systems are of limited effectiveness and should serve as tools to assist and support a clinical decision rather than as determinants of conduct. In the emergency department, one of two treatment options must be adopted: early complete treatment or staged treatment. The former consists of definitive fixation and immediate skin coverage, using either primary closure (suturing) or flaps, and is usually reserved for less complex cases. Staged treatment is divided into initial and definitive. The objectives in the first phase are: prevention of the progression of ischemia, necrosis and infection. The principles of definitive treatment are: proximal-to-distal bone reconstruction, anatomic foot alignment, fusions in severe cartilage lesions or gross instabilities, stable internal fixation and adequate skin coverage. Level of evidence III, Systematic review of level III studies.</jats:p>
    Scopus© Citations 7  1