Limited Internal Fixation of Pilon Fractures

Han, Sung Ho; Yang, Bo Kyu; Kim, Chi Hong; Ahn, Tae Won; Chu, Wu Jun

Abstract

Pilon fracture is relatively an uncommon fracture involving the distal tibial articular surface. As usually being combined with many complications, it is difficult to manage. Among many treatment options limited internal fixation of the tibia with long screws and multiple pins augmented with external fixation or casting provide adequate stabilization without soft tissue compromise. Fractures were defined as type II in 10 fractures and type III in 16 by Ruedi-Allgowers classification. 16 fractures, 6 type II and 10 type III, had limited internal fixation and cast application. 1 type III fracture had limited internal and external fixation. 9 fractures, 4 type II and 5 type III, were treated by rigid tibial plating during a period of 5 years(Mar. 1990- Fed. 1995). By Burwells and Charnleys radiological criteria and clinical grading system, limited internal fixation showed 67% satisfactory results in type II and 64% in type III fractures while rigid tibial plating showed 75% satisfactory results in type II and 60% in type III fractures. 4(44%) patients with rigid tibial plating, and 2(12%) patients with limited internal fixation had complications. Pilon fractures are high energy injuries with significant associated soft tissue damage. limited internal fixation offers good solution to this difficult fracture problem.