Treatment of Tibial Pilon Fractures with Two-Staged Delayed Open Reduction and Internal Fixation

Sohn, Hong Moon; Lee, Jun Young; Ha, Sang Ho; Choi, Sung Min

Abstract

PURPOSE
To evaluate the short-term results of two-staged delayed open reduction and internal fixation in tibial pilon fractures with severe soft tissue damages. MATERIALS AND METHODS: Eleven patients, who underwent two-staged delayed open reduction and internal fixation for tibial pilon fractures between January 2002 and July 2003, were followed for more than one year. The mean interval time between first stage and second stage of the procedures was 28.5 days (range, 14-34 days). Radiographs were graded by the criteria of Burwell and Charnley and ankle functions were graded by the criteria of Mast and Teipner. Ankle function, union time and postoperative complications were also analysed. RESULTS: Average union time was 17 weeks (range, 14-20 weeks) in ten of the eleven fractures, but there was one fracture resulting in soft tissue complication and infected nonunion. At the lastest follow-up, review of the radiographic results showed that eight fracture (73%) achieved an anatomic reduction, two (18%) achieved a fair reduction, and one (9%) achieved a poor reduction. And clinical functional assessment showed that there were seven (64%) good results, three (27%) fair results, and one (9%) poor result. CONCLUSION: Two-staged delayed open reduction and internal fixation technique is an excellent option for the treatment of tibial pilon fractures with severe soft tissue injuries.