UNASSIGNED: Tibial pilon fractures, involving the weight-bearing surface of the distal tibia,present a formidable challenge for orthopedic surgeons due to their complex nature and the delicate soft tissue envelope surrounding the ankle joint.Early approaches to pilon fracturesoften resulted in poor outcomes, but modern principles of internal fixation and anatomicalreconstruction have significantly improved patient prognosis. Despite advancements in surgicaltechniques and implants, achieving anatomical reduction of the articular surface remains asignificant hurdle.
UNASSIGNED: This article presents a case report of a 27-year-old male soldier who sustained bilateral tibial pilon fractures following a fall from height. The patient underwent surgical intervention with differing approaches due to the complexity of the fractures. A combination of minimally invasive plate osteosynthesis (MIPPO) and external fixation was employed to address the fractures. The patient was followed up for 06 months post-op.
UNASSIGNED: The importance of respecting the soft tissue envelope in surgical planning and timing, as well as the role of advanced imaging techniques such as CT scanning in preoperative assessment is crucial to achieving a successful outcome.While tibial pilon fractures remain complex injuries, advancements in surgical management have led to improved outcomes. However, ongoing research and innovation are necessary to address the multifaceted challenges associated with these fractures and optimize patient care.

UNASSIGNED: Galeazzi fractures are fractures of the radial shaft accompanied by distal radioulnar joint (DRUJ) instability. They usually occur due to a mechanical fall or direct trauma to the wrist or forearm. Management of this serious injury varies from non-operative treatment with closed reduction and splinting to operative fixation using an external fixator (ex-fix) or open reduction internal fixation with plate and screws.
UNASSIGNED: We present a 76-year-old female who presented with a right distal radius fracture after a ground-level fall. Due to fracture displacement after initial conservative management, she was placed in an external fixator for stabilization. After removal of the ex-fix, she sustained a midshaft radius fracture with DRUJ malalignment, consistent with a \"Galeazzi-like\" fracture.
UNASSIGNED: \"Galeazzi-like\" fractures with associated DRUJ malalignment can occur from previous external fixator pin sites and are adequately treated with standard operative fixation.

UNASSIGNED: External fixation devices are commonly used in orthopaedic surgery to manage a range of pathologies. In this patient population, there is currently no consensus on optimal rehabilitation techniques. There exists a large variation in practice, with a limited understanding of how these affect treatment outcomes.
UNASSIGNED: Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, a systematic review was conducted of Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PEDro, and COCHRANE databases, grey literature sources and forward and backward searching of included articles. Studies were selected following rigorous screening with predefined inclusion criteria. Data quality was assessed using validated appraisal tools. Articles were synthesised by rehabilitation type and descriptive analysis was subsequently performed.
UNASSIGNED: From 1,156 articles identified, 18 were eligible for inclusion. The overall quality was low, with clinical commentaries and case studies being the most common study type. Studies were synthesised by rehabilitation type, the most common themes being gait re-education, strengthening, therapy-assisted, active exercises and weight-bearing exercises.
UNASSIGNED: There is a lack of high-quality evidence to support meaningful recommendations and guide rehabilitation practices for this patient cohort. Further research for patients being treated in external fixation, especially related to the potential effects of physical rehabilitation on bone healing, return of strength, mobility and independent function is likely to have transferability within wider orthopaedic populations.
UNASSIGNED: This systematic review is unable to provide clinical recommendations due to the poor quality of the available literature. However, it is hoped this paper will provide a foundation for further research to improve rehabilitation for patients being treated with external fixation.
UNASSIGNED: Pawson JR, Church D, Fletcher J, et al. Rehabilitation Techniques for Adults Undergoing External Fixation Treatment for Lower Limb Reconstruction: A Systematic Review. Strategies Trauma Limb Reconstr 2024;19(1):45-55.

UNASSIGNED: Albeit rare, open pelvic fractures are life threatening injuries associated with significant morbidity and mortality. Due to their rarity, there is paucity of data and literature on best management practices. An open pelvic fracture is one where there is a connection between the fracture site and either the skin, rectum, vagina, or genitourinary system. They commonly affect young individuals involved in high energy injuries. During resuscitation, prompt recognition and control of sepsis and stabilization of unstable fractures should precede definitive management.
UNASSIGNED: We conducted a retrospective study of prospectively collected data between 2012 and 2022 for patients managed in two teaching hospitals in Kenya. All patients were followed up for at least 6 months. The Faringer classification was used to classify the soft tissue wounds and the Young and Burgess classification was used to classify the pelvic fractures. We investigated their functional outcomes using their ability to ambulate independently and the Merle d\' Aubigne-Postel score.
UNASSIGNED: Eight patients with an average age of 31 years were included. All were referrals. Three (37.5 %) developed sepsis but resolved. Four (50 %) needed a diverting stoma, which included 2 of the 3 patients who had developed sepsis. 5(62.5 %) needed an external fixator as part of definitive management. There were no mortalities. All achieved full independent ambulation; and all our patients achieved an average Merle d\' Aubigne-Postel score of 17.
UNASSIGNED: Our study demonstrates that early sepsis control, appropriate fracture fixation and a multidisciplinary approach can yield satisfactory functional outcomes.