The comparative analysis between emergency one-stag and delayed the step-by-step open reduction and internal fixation in treatment of Pilon fracture

Abstract

Objective To compare the clinical effects between emergency one-stag and delayed the step-by-step open reduction and internal fixation (ORIF) in treatment of Pilon fracture.Methods The clinical and follow-up data of 41 patients with Pilon fracture treated by emergency one-stag ORIF (18 patients,Ⅰ period group) and delayed the step-by-step ORIF(23 patients,delayed group) were retrospectively analyzed.The Mazur ankle function score,complications and result of the post-operation radiological examination were compared and analyzed.All patients were followed up for 5-24 months after surgery.Results The excellent and good rate in Ⅰ period group [66.7％(12/18)] was significantly lower than that in delayed group [82.6％ (19/23)] (P ＜0.05).According to Burwell-Charnley radiological examination standard,in Ⅰ period group,anatomic reduction in 4 patients,good reduction in 10 patients,bad reduction in 4 patients.In delayed group,anatomic reduction in 12 patients,good reduction in 10 patients,bad reduction in 1 patient.The rate of reduction between two groups had significant difference (P ＜ 0.05).Eight patients had wound infection and cutaneous necrosis in Ⅰ period group and 2 patients in delayed group (P ＜0.05).Six patients had traumatic occlusion osteoarthritis in Ⅰ period group and 1 patient in delayed group (P ＜ 0.05).Six patients had anchylosis in Ⅰ period group and 2 patients in delayed group (P ＜ 0.05).Three patients had fracture delayed union and disunion in Ⅰ period group and 1 patient in delayed group (P ＞0.05).Conclusions The delayed the step-by-step ORIF in treatment of Pilon fracture may avoid the complications of soft tissue and provide clinical results.This method has preventive and therapeutic action for others complications and is good in treatment for Pilon fracture. Key words: Pilon fracture; Two-stage delay operation; Internal fixation