Abstract
Objective To explore the clinical outcomes of treating phalangeal Pilon fractures with closed reduction and external fixator stretch fixation.Methods From October 2008 to December 2012,twenty-four patients with Pilon fractures of the phalanx were treated with stretch fixation by an external fixator.There were 16 males and 8 females.Their ages ranged from 24 to 61 years,with an average of 45.5 years.Of the 24 cases,14 had only Pilon fractures.The rest had concomitant fractures of metacarpal or phalangeal shaft or partial/complete tendon ruptures.Pilon fractures were all closed,intra-articular fractures of the proximal interphalangeal joint.All the Pilon fractures were treated with closed reduction and external fixator stretch fixation.Results Postoperative follow-up ranged from 6 months to 2 years with an average of 8 months.The external fixator was removed at 4 weeks postoperatively in 1 patient,at 5 weeks in 10 patients,and at 6 weeks in 13 patients.There was neither loosening of the fixator nor pin track infection.Functional exercise resumed after external fixator removal.The time of fracture healing was 4 to 8 weeks,the average being 6 weeks.Rotational deformity of 20° was noted in one case.Residue fracture chips inside the joint cavity were seen in 5 cases.These intra-articular bone chips affected joint movement in 2 cases that warranted surgical removal of the bone chips.According to the functional evaluation criteria based on total active movement,the results were rated as excellent in 5 cases,good in 16 cases,fair in 2 cases,and poor in 1 case.The overall excellent and good rate was 87.5％.Conclusion Closed reduction and external fixator stretch fixation is a simple,convenient and practical method to treat Pilon fractures of the phalanx.It leads to reliable fixation,good joint function recovery and satisfactory short-term clinical outcomes. Key words: Phalanx; External fixator; Closed reduction; Stretch fixation; Pilon fractures
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