Limited Internal Fixation for the Treatment of the Pilon Fracture

Chung, Phil Hyun; Kang, Suk; Mun, Sang Ho; Chae, Won Suk

Abstract

The intraarticular fractures of the distal tibia-so called pilon fracture or plafond fracture- were caused by high energy and axial compression forces arising from motor vehicle accidents or falls from a height, and it is frequently associated with severe vomminution and soft tissue injury. Expecially soft tissue injury has been considered as a difficult problems to treat these fractures and there has been many controversies in the methods of treatment. We analized 30 cases of pilon fracture who were treated by limited internal fixation from March 1992 to March 1997. the average follow up period was 26 months(from 15 to 50 months). The results as follow: 1. According to Ruedi and Allgower classification, Type I were 4(13%), Type II were 14(46%) and Type III were 12(40%) cases. 2. By using Ovadia and Beals' radiologic assessment, limited internal fixation showed good and fair results in about 80% of cases. 3. By using Mast and Teipner's clinical functional assessment, limited internal fixation showed good and fair reults in about 80% of cases. 4. Complications after operation were traumatic arthritis(17%) and nonunion(3.3%). But there were no complications such as wound infection and skin necrosis. Limited internal fixation with casting provides good result to treat pilon fractures and it reduces the complications of soft tissues problem.