Limited open reduction and internal fixation with anatomical locking compression plate for treatment of tibial Pilon fractures

Abstract

Objective To investigate methods and clinical effects of limited open reduction of ankle articular surface and locking compression plate (LCP) placement using minimally invasive plate osteosynthesis (MIPO) in managing tibial Pilon fractures.Methods Twenty-one patients with tibial Pilon fractures treated between August 2009 and August 2011 were involved in the study,including 16 males and 5 females,at age of 21-68 years (average 42.3 years).According to AO/OTA classification,12 patients were with type 43B fractures and nine with type 43C fractures.There were two patients with open fractures (both Gustilo-Anderson type Ⅰ fractures).Limited open reduction of ankle articular surface plus LCP placement using MIPO were performed.Early functional training without weight-bearing was carried out postoperatively.Results Nineteen patients were followed up for 12-24 months (average 14 months).According to Burwell-Chamley' s radiological evaluation system,17 patients obtained anatomical reduction of articular surface and two patients obtained moderate reduction,but they all had bony healing.Ankle function evaluated by Mazur' s criterion were excellent in seven patients,good in 10 and fair in two,with excellence rate of 89％.Conclusion Limited open reduction combined with LCP internal fixation can successfully construct articular anatomic relationship,decrease soft tissue dissection and attain solid fixation in treatment of Pilon fractures and further facilitate functional recovery of the affected extremity in coordination with early functional exercise. Key words: Tibial fractures ; Skeletal tracting reposition; Fracture fixation, internal; Locking compression plate; Pilon fracture