BOFAS Abstracts Archive

You can search for abstracts by using the search bar below.
Alternatively you can browse through podium and poster presentations by selecting the year and / or type below. You can further refine your search using tags or use the search bar.

Search

RSS Abstracts 476 Expand/Collapse
- RSS 2013 64 Expand/Collapse
  - RSS Poster 24 Expand/Collapse
  - RSS Podium 40 Expand/Collapse
- RSS 2014 36 Expand/Collapse
  - RSS Podium 36 Expand/Collapse
- RSS 2015 49 Expand/Collapse
  - RSS Poster 20 Expand/Collapse
  - RSS Podium 29 Expand/Collapse
- RSS 2016 45 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 27 Expand/Collapse
- RSS 2017 40 Expand/Collapse
  - RSS Poster 15 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2018 47 Expand/Collapse
  - RSS Poster 22 Expand/Collapse
  - RSS Podium 25 Expand/Collapse
- RSS 2019 48 Expand/Collapse
  - RSS Poster 25 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2021 15 Expand/Collapse
  - RSS Poster 10 Expand/Collapse
  - RSS Podium 6 Expand/Collapse
- RSS 2022 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2023 46 Expand/Collapse
  - RSS Poster 23 Expand/Collapse
  - RSS Podium 23 Expand/Collapse
- RSS 2024 40 Expand/Collapse
  - RSS Poster 18 Expand/Collapse
  - RSS Podium 22 Expand/Collapse

Categories: Abstracts, 2023, Podium

The acute management of pilon fractures (ENFORCE) study: a trainee led national collaborative evaluation of practice

D. Hill, J. Davis

¹Torbay and South Devon NHS Foundation Trust, Trauma and Orthopaedic Surgery, Torquay, United Kingdom

Introduction: Tibial Pilon fractures are potentially limb threatening, yet standards of care are lacking from BOFAS and the BOA. The mantra of “span, scan, plan” describes staged management with external fixation to allow soft tissue resuscitation, followed by a planning CT-scan. Our aim was to evaluate how Tibial Pilon fractures are acutely managed.

Methods: ENFORCE was a multi-centre retrospective observational study of the acute management of partial and complete articular Tibial Pilon fractures over a three-year period. Mechanism, imaging, fracture classification, time to fracture reduction and cast, and soft tissue damage control details were determined.

Results: 656 patients (670 fractures) across 27 centres were reported. AO fracture classifications were: partial articular (n=294) and complete articular (n=376). Initial diagnostic imaging mobilities were: plain radiographs (n=602) and CT-scan (n=54), with all but 38 cases having a planning CT-scan. 526 fractures had a cast applied in the Emergency Department (91 before radiological diagnosis), with the times taken to obtain post cast imaging being: mean 2.7 hours, median 2.3 hours, range 28 mins – 14 hours). 35% (102/294) of partial articular and 57% (216/376) of complete articular (length unstable) fractures had an external fixator applied, all of which underwent a planning CT-scan. Definitive management consisted of: open reduction internal fixation (n=495), fine wire frame (n=86), spanning external fixator (n=25), intramedullary nail (n=25), other (n=18).

Conclusion: The management of Tibial Pilon fractures is variable, with prolonged delays in obtaining post cast reduction radiographs, and just over half of length unstable complete articular fractures being managed with the gold standard “span, scan, plan” staged soft tissue resuscitation. A BOFAS endorsed BOAST (British Orthopaedic Association Standard for Trauma) for Tibial Pilon fractures is suggested for standardisation of the acute management of these potentially limb threatening injuries, together with setting them apart from more straightforward ankle fractures.

Print

Tags: Ankle Fracture Hindfoot Trauma

Documents to download

The acute management of pilon fractures (ENFORCE) study: a trainee led national collaborative evaluation of practice(.pdf, 359.55 KB) - 429 download(s)

Click thumbnail below to view poster / thumbnail:

Archive of Abstracts