Gait analysis and clinical outcome in patients after pilon fracture surgery

Michaël Houben; Sander van Hoeve; Bernard S Leenstra; Paul Willems; Kenneth Meijer; Martijn Poeze

doi:10.1016/j.fas.2022.04.002

Gait analysis and clinical outcome in patients after pilon fracture surgery

Foot Ankle Surg. 2022 Dec;28(8):1229-1234. doi: 10.1016/j.fas.2022.04.002. Epub 2022 Apr 22.

Authors

Michaël Houben¹, Sander van Hoeve², Bernard S Leenstra³, Paul Willems⁴, Kenneth Meijer⁵, Martijn Poeze⁶

Affiliations

¹ Department of Surgery, division of Trauma surgery, Maastricht University Medical Center. P. Debyelaan 251. PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: michael.houben@hotmail.com.
² Department of Surgery, division of Trauma surgery, Maastricht University Medical Center. P. Debyelaan 251. PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: s.vanhoeve@hotmail.com.
³ Department of Surgery, division of Trauma surgery, Maastricht University Medical Center. P. Debyelaan 251. PO Box 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: b.leenstra@alumni.maastrichtuniversity.nl.
⁴ Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25. PO Box 616, 6200 MD Maastricht, The Netherlands; NUTRIM, School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: paul.willems@maastrichtuniversity.nl.
⁵ Department of Movement Sciences, Maastricht University Medical Center, P. Debyelaan 25. PO Box 616, 6200 MD Maastricht, The Netherlands; NUTRIM, School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: kenneth.meijer@maastrichtuniversity.nl.
⁶ Department of Surgery, division of Trauma surgery, Maastricht University Medical Center. P. Debyelaan 251. PO Box 5800, 6202 AZ Maastricht, The Netherlands; NUTRIM, School for Nutrition and Translational Research in Metabolism, PO Box 616, 6200 MD Maastricht, The Netherlands. Electronic address: m.poeze@mumc.nl.

PMID: 35562225
DOI: 10.1016/j.fas.2022.04.002

Abstract

Background: In this study kinematic parameters, radiographic findings and PROM in pilon fractures after operative treatment were compared with healthy subjects.

Methods: 16 patients treated with osteosynthesis after pilon fracture underwent kinematic analysis with the OFM. Fractures were evaluated for post-operative step-off and gap on CT-scans and PROM were collected. Results were compared to 10 healthy persons.

Results: Range of motion (ROM) crural was lower in the flexion/extension for pilon fractures (10.03 vs. 13.15, p = 0.017). The ROM in the inversion/eversion was low, but ROM in the abduction/adduction was higher. Correlations were found between flexion/extension and AO-classification (r = -0.357 p < 0.05), PROM score of the AOFAS (r = 0.445 p < 0.01), post-operative gap and step-off in the tibia plafond.

Conclusion: Pilon fractures showed decreased ROM between the hindfoot and tibia in the sagittal and transverse plane, but increased ROM in the frontal plane during push-off phase as compensatory kinetics. ROM showed significant correlations with PROM and intra-articular step-off and gap in the tibia plafond.

Keywords: Functional outcome; Gait analysis; Pilon fractures; ROM; Radiographic reduction.

MeSH terms

Ankle Fractures* / diagnostic imaging
Ankle Fractures* / surgery
Fracture Fixation, Internal / methods
Gait Analysis
Humans
Retrospective Studies
Tibial Fractures* / diagnostic imaging
Tibial Fractures* / surgery
Treatment Outcome