Description
ALEX TROMPETER, a surgeon from London, discusses the complexities of treating pilon fractures during a presentation. He reflects on a previous session where he spoke to framers and contrasts that with his current talk aimed at a group of framers, emphasizing the shared goals for patient treatment, regardless of the method used. Trompeter notes the lack of definitive randomized controlled trials for framing versus plating treatments, suggesting both have supporting evidence. He highlights the poor long-term outcomes often associated with pilon fractures, especially in high-energy scenarios, and advocates for meticulous surgical techniques in soft tissue management.
He stresses the importance of thorough debridement and ensuring a clean surgical environment before fixation, arguing against traditional methods that might compromise patient outcomes. Trompeter presents his pragmatic approach to surgery, favoring a combined approach in fractures for optimal alignment and stability while minimizing infection risks.
The discussion incorporates historical perspectives on fixation techniques and critiques current practices while proposing a shift towards better column restoration strategies. He highlights specific case studies illustrating significant drops in infection rates following improved surgical techniques and emphasizes a focus on maintaining alignment, stability, and restoring distal tibial geometry to enhance patient outcomes.