Clinical Evaluation for the Tibial Pilon Fractures

Song, Kyung Jin; Jung, Joo Won; Lee, Joo Bong; Park, Myung Sik; Bwang, Byung Yun

Abstract

Treatment for the tibial Pilon fractures involving ankle joint must be the most challenging one in the long bone fractures following lots of complications. We analyzed fourteen patients those who underwent surgical treatment for distal tibia fracture extending through the tibial plafond into the ankle joint. Under the Ruedi and Allgower classification two were in type I, two were in type II and ten were in type III. The Mean follow-uP Period was four years ranging from two to seven years. The purpose of this paper is to evaluate the treatment results of tibia Pilon fractures and analyBe the causes of complications. In surgical treatment method, we tried early open reduction and rigid internal fixation as far aas possible in the closed pilon fracture. We assessed the function under the objective and sutjective criteria of Ovadia and Beals. Two out of two in type I, one out of two in type II and four out of ten in type III Pilon fractures obtained good functional outcome. There were 3 wound infections, 1 malunion with reflex sympathetic dystrophy and 2 traumatic osteoarthritis as a complication. Type I and type II Pilon fractures proved to be amenable to open reduction, restoration of anatomic position, and stable internal fixation with early joint exercise. Nonanatomic reduction, unstable fixation, infection, and secondary arthrosis were associated in type III Pilon fractures with poor functional outcome after surgical treatment.