The Results of the Operative Treatment of Pilon Fractures

Abstract

Aim: With this study we present the results of the treatment of pilon fractures with the method of external and minimal internal fixation. Material and Method: In our department during the period 1996-2001 twenty (20) pilon fractures were treated; 3 were open (two type II and one type III a according to Gustillo-Anderson classification) and 17 were closed (three type I, 11 type II and 3 type III according to Ruedi-Allgower classification). All these fractures were treated with external fixation (in three of them with hybrid external fixator) combined with minimal internal fixation. In order to achieve intraarticular reduction, small incisions were used with the least possible damage to the soft tissues. Cancellous bone grafts were applied whenever as necessary. In open fractures that was done when the possibility of infection was excluded. Results: The average follow-up period was 22 (8-39) months. One patient was lost during this period. The results were 85 % excellent and good, 7 % fair and 7 % poor. Seventeen (85 %) of the fractures united and the average union time was 4 months. The complications were: a) pin-tract infection in three patients, which was treated conservatively with local care and antibiotics, b) varus malunion in one patient, c) non-union in 2 patients, which were treated with bone grafting and d) osteoarthritic changes in the ankle joint in 2 patients. There was no infection at the fracture site and all the wounds healed primarily without need for skin grafting.