{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T02:48:07Z","timestamp":1780541287695,"version":"3.54.1"},"reference-count":21,"publisher":"SLACK, Inc.","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2010,8,11]]},"abstract":"<jats:p>\n            Open treatment of pilon fractures is associated with wound healing complications. A traumatized, limited soft tissue envelope contributes to wound healing complications. Obese patients have larger soft tissue envelopes around the ankle, theoretically providing a greater area for energy distribution and more accommodation to implants. This led us to test 2 hypotheses: (1) ankle dimensions in obese patients are larger than in lean patients, and (2) the increased soft tissue envelope volume translates into fewer wound complications. A consecutive series of 176 pilon fractures treated from March 2002 to December 2007 were retrospectively reviewed. Inclusion criteria were adults who received a preoperative computed tomography (CT) scan and were treated with a staged protocol including plating. Patients with body mass index (BMI) &gt;30 were compared to those with BMI &lt;30 for CT-derived ankle dimensions and wound complications. Comorbidities were evaluated for their role as potential confounders. Thirty-one fractures in obese patients were compared to 83 in lean patients. The average ratio of bone area to soft tissue area at the tibial plafond was 0.35 for the obese group and 0.38 for the lean group (\n            <jats:italic>P<\/jats:italic>\n            =.012). There were 8 major wound-healing complications. Four occurred in the obese group (incidence 13%), and 4 in the lean group (incidence 5%) (\n            <jats:italic>P<\/jats:italic>\n            =.252). Ankle dimensions in clinically obese patients are larger than in lean patients. Obesity does not appear to be protective of wound-healing complications, but rather there is a trend toward the opposite.\n          <\/jats:p>","DOI":"10.3928\/01477447-20100625-27","type":"journal-article","created":{"date-parts":[[2010,8,12]],"date-time":"2010-08-12T15:58:01Z","timestamp":1281628681000},"source":"Crossref","is-referenced-by-count":18,"title":["Is Obesity Protective Against Wound Healing Complications in Pilon Surgery? Soft Tissue Envelope and Pilon Fractures in the Obese"],"prefix":"10.3928","volume":"33","author":[{"given":"Matthew L.","family":"Graves","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott E.","family":"Porter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryan C.","family":"Fagan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glenn A.","family":"Brien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew W.","family":"Lewis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus D.","family":"Biggers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Woodall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George V.","family":"Russell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2308","reference":[{"issue":"1","key":"e_1_3_1_2_2","first-page":"39","article-title":"Therapeutic procedure and long-term results in tibial pilon fracture in relation to primary soft tissue damage","volume":"97","author":"Rommens PM","year":"1994","unstructured":"Rommens PM, Claes P, De Boodt P, Stappaerts KH, Broos PL. Therapeutic procedure and long-term results in tibial pilon fracture in relation to primary soft tissue damage. Unfallchirurg. 1994; 97(1):39\u201346.","journal-title":"Unfallchirurg"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-200006000-00010"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200103000-00002"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e318145a227"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200310000-00005"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200007000-00006"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-199312000-00001"},{"issue":"2","key":"e_1_3_1_9_2","first-page":"85","article-title":"Therapeutic strategy in pilon fractures type C2 and C3: soft tissue damage changes treatment protocol","volume":"96","author":"Rommens PM","year":"1996","unstructured":"Rommens PM, Claes P, Broos PL. Therapeutic strategy in pilon fractures type C2 and C3: soft tissue damage changes treatment protocol. Acta Chir Belg. 1996; 96(2):85\u201392.","journal-title":"Acta Chir Belg"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199307000-00013"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005131-200409001-00005"},{"issue":"1","key":"e_1_3_1_12_2","first-page":"1","article-title":"Fracture and dislocation compendium. Orthopedic Trauma Association Committee for Coding and Classification","volume":"10","year":"1996","unstructured":"Fracture and dislocation compendium. Orthopedic Trauma Association Committee for Coding and Classification. J Orthop Trauma. 1996; 10(1):1\u2013S154.","journal-title":"J Orthop Trauma"},{"key":"e_1_3_1_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000222562.60260.f9"},{"issue":"4","key":"e_1_3_1_14_2","first-page":"319","article-title":"Late results after operative treatment of fractures of the distal tibia (pilon tibial fractures) [in German]","volume":"81","author":"Ruedi T","year":"1978","unstructured":"Ruedi T, Allgower M. Late results after operative treatment of fractures of the distal tibia (pilon tibial fractures) [in German]. 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