Radiological and functional assessment of the tibial pilon fractures treated by Ilizarov external fixation

Abstract

Background & Objectives: The tibial pilon fractures are one of the challenging fractures in Orthopaedics because of limited soft tissue coverage and vicinity to the articular surface. Open reduction methods breach the soft tissue, which can result in serious complications. Ilizarov external fixation is minimally invasive and yields good clinical & radiological results with comparatively less complications.Methods: The study was conducted with 27 subjects in the age group of 18 – 80 years, between September 2014 and June 2016. Follow-up was done at 1 month, 3 months, 6 months and before completion of study for Radiological outcome using Teeny-Wiss scoring system, Clinical results using Ovadia-Beals criteria and Foot and Ankle Outcome score.Results: 27 patients with average age of 44 years were studied. 20 cases were closed injuries and 7 were open. Most common cause was Road Traffic Accidents (21 cases), fall from height (5 cases) and a bomb blast injury. We achieved excellent & good Clinical results in 18 cases and radiologically anatomic & good reduction in 19 cases. 3 cases had nonunion and 11 cases had soft tissue complications. There were no cases of ankle arthrodesis or amputations or Deep vein thrombosis. The FAOS and EQ5D scores were tabulated.Conclusion: The common complications associated with Ilizarov external fixation being treatable on outpatient basis in most of the patients, makes this a better choice even in complicated cases. Patient compliance and meticulous follow-up are very important limiting factors.