Abstract
Background: The present study aims to compare the results of primary tibial pilon injury . Objective: Our work aims to compare the clinical and radiological outcomes of two different surgical techniques for treatment of tibial pilon fractures. Patients & Methods: Those who matched completely with inclusion criteria were included until fully gaining required sample size. Prospective comparative controlled study using the foot and ankle outcome questionnaire of AAOS. The study was carried on patients with distal tibial fractures that are types 43 (B&C1, C2, C3) OTA classification of distal tibial fractures. patients divided for two groups according to surgical technique: group (A):(30) patients managed with primary external fixator with screws. group (B):(30) patients Managed with staged ORIF. Results: Group B showed a higher AAOS Foot and Ankle Normative score and AAOS foot and ankle core scale standardized mean and shoe comfort standardized mean and shoe comfort normative score and SF36 physical functioning% than Group A. Group A showed a less time interval from injury till fixation than Group B. From statistical point of view the two groups showed no significant difference regarding incidence of acquired complications. Conclusion: The two-stage ORIF gained a reduced risk of postoperative complications related to superficial infections, and bone healing problems. The ORIF 2 stage has several advantages, such as the ability to handle soft tissues including the periosteum, tendons(PTT), and ligaments that may be contained within fragmented fracture .
Highlights
Tibial plafond fractures are life-changing events that affect the patient's life
Reduction techniques: Operative procedure using external fixator aided with screws maneuver: Done closed mainly with percutaneously reducing the major articular parts, and fixation by supplementary internal fixation with either percutaneous screws Or wires under the image intensifier, or through open reduction and fixation with screws we fixed the hinged block to the shaft and the metaphyseal area, an external fixation framework is applied with the aim of preserving reduction
Regarding SF36 Questionnaire, there was no significant difference between the two groups except for physical functioning which was higher in group B, (P value =0.012)
Summary
Tibial plafond fractures are life-changing events that affect the patient's life It keeps a unique place as an ideal opposing traumatic injury to each orthopedist. The main goals in treating such injuries are to reconstruct the articular surface that should be repaired conveniently and modulary, along with stable fixation that allows for an early range of motion to avoid stiffness. All these goals must be taken into account regarding the state of the soft tissues as it is the mostly affected injury site. 8. Tibial plafond fractures are life-changing events that affect the patient's life. The ORIF 2 stage has several advantages, such as the ability to handle soft tissues including the periosteum, tendons(PTT), and ligaments that may be contained within fragmented fracture
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