![]() ![]() ![]() And so it would seem that I’ve been getting smarter… Go figure. And just beforehand, in Cody, I climbed for three incredible days with Justin Woods, who’s a paramedic and also does wilderness med and rescue work. Irony number 800 – upon seeing my friend Pete Tapley in the parking lot that morning – Pete was my partner in the Black Magic post from all those years ago – we joked how I’m smart to climb with a doc. My thanks to them, including Adam and Brooke, who were running the deal, and were professional, patient, and endured my filthy language without flinching.įeeling great on the sixth pitch of "Broken Hearts," in Cody, a few days before. Steve ran out – 13 people from a Montana Wilderness School of the Bible outing, doing a snow camping and winter climbing course. Side note, along the lines of “Hey, anybody here order a pizza?” fairytales: Near the bottom of the canyon, close to the trail but with some hard, steep terrain to go, we heard voices. ![]() It took four sans-painkiller hours of him pulling me, pushing me, lifting me, me pushing up, me doing sit-ups, and just keeping it all in perspective, but he got me out. He could not have done any better, and his splinting and care surely help my long-term prognosis. He did an incredible job splinting my grotesque, bones-grinding-together lower leg and getting me out. I’m grateful to have been with my good friend Steve Halvorson, who’s a longtime climbing partner, an ER doc, and teaches wilderness medicine and rescue courses. There’s a fair bit going through my mind and I’m a little loopy, a little rougher than even normal, so pardon the sketchy writing. I’ll write more about the details as time passes – I’ll be having considerably more free time, which I’ll put to good use watching TV, writing, and, most importantly, drinking margaritas (hey, at least that part’s good, right? There we go, always looking for that silver lining…). Logistically, the problem is that it’s close to the ankle joint, which greatly increases the complexity of the repair and the long-term recovery prospect. Perhaps the worst thing about fracturing my tibia & fibula – with a “Pilon Fracture” and the tibia end “heavily comminuted” – pulverized, turned to powder – wasn’t just the pain, which definitely hurt, but the psychological impact of seeing my right foot and lower leg flopping from side-to-side. While climbing, I was everything but Sketchy Kelly – I climbed well, placed lots of pro, even protected the easy exit ice, even backed-up our anchor. Besides, perspective is good, and so it’s all the more ironic that my disintegrated leg and perhaps disintegrated climbing future happened in Hyalite, but didn’t even happen while climbing. I’ve never wanted to take myself too seriously, and enjoy laughing about the Sketchy Kelly days – as I did in my last post. ORIF ankle fibula fracture outcomes pilon plafond recovery tibia time trauma.Well, damn. This information is helpful in counseling patients and setting expectations for recovery after pilon fractures. Furthermore, the mean PROMIS PF score of patients 2 years after recovery was approximately 1 SD below the population average. No significant difference was detected in PF scores after 6 months postoperatively up to 2 years. Patients with isolated pilon fractures demonstrate the majority of their improvement in terms of physical function between 6 weeks and 6 months postoperatively. Otherwise, no significant differences were detected between consecutive time points. There was a significant difference between PROMIS PF scores between 6 weeks and 3 months ( P <. The average PROMIS PF score was 28 immediately postoperatively, 30 at 6 weeks, 36 at 3 months, 40 at 6 months, 41 at 1 year, and 39 at 2 years. There were 160 patients with PROMIS scores immediately postoperatively, 143 patients at 6 weeks, 146 patients at 12 weeks, 97 at 24 weeks, 84 at 1 year, and 45 at 2 years postoperatively. Patient-Reported Outcomes Measurement Information Systems (PROMIS) Physical Function (PF) scores from these patients at defined follow-up times of immediately, 6 weeks, 3 months, 6 months, 1 year, and 2 years after surgery defined the cohorts and were retrospectively studied. ![]() The patients studied sustained a unilateral, isolated pilon fractures (AO/OTA 43B/C) and followed at a level 1 trauma center over a 5-year period (2015-2020). The purpose of this study was to determine the trajectory and rate at which patients' physical function improves up to 2 years postinjury. The time frame in which patients can expect functional improvement after open reduction internal fixation (ORIF) of pilon fractures is unclear. ![]()
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