Treatment of Tibial Pilon Fractures using Ring Fixators and Arthroscopy

Kim, Hak Sun; Jahng, Jun Seop; Kim, Sang Soo; Chun, Churl Hong; Han, Hong Jun; Lee, Sung Ho

Abstract

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.