Clinical feasibility of staged delayed surgery for patients with high energy Pilon fractures

Abstract

Objective To investigate the feasibility of staged delayed surgery for patients with high energy Pilon fractures. Methods 70 patients with Pilon fracture treated at our department were divided into a control group, treated with early open reduction and internal fixation, and an observation group, treated with staged delayed surgery. The hospital stay, time for being ill in bed, operation time, intra-operative bleeding volume, and levels of angiotensin II (ATII), renin (R), norepinephrine (NE), epinephrine (E), etc. were recorded. 3, 8, and 12 months after the operation, the ankle joint scores were observed. The iconographic fracture healing time and time for weight-bearing were recorded. Results The hospital stay, time for being ill in bed, and operation time were shorter and the intra-operative bleeding volume was lower in the observation group than in the control group. The levels of ATII, R, NE, and E were significantly lower in the observation group than in the control group. 3, 8, and 12 months after the operation, the ankle joint scores were higher in the observation group than in the control group. The iconographic fracture healing time and time for weight-bearing were (110.25±13.12) d and (164.20±20.31) d in the observation group, which were shorter than those in the control group. Conclusions Staged delayed surgery for high energy Pilon fractures can shorten operation time, reduce trauma and stress, and accelerate ankle joint function improvement, so that the patients can have early postoperative ambulation, so it is worth being generalized. Key words: High energy Pilon fractures; Staged delayed surgery; Ankle joint function; Internal fixation