The role of AGH classification for treatment strategies of the posterior pilon fractures

Abstract

Objective To explore the role of AGH classification in operation for posterior pilon fractures. Methods Between January 2012 and June 2015, eighteen consecutive patients with posterior pilon fractures were managed in our trauma center, including 11 males and 7 females with the mean age of 46.8 years. There were 10 left ankles and 8 right ankles. Patient re-cords were reviewed to decide operative approaches and procedures according to our proposed AGH classification system: type I, a single complete fracture fragment; type II, a posterior malleolus fracture with 2 subtypes; type Ⅲ, a posterior malleolus fracture as-sociated with complete medial malleolus fracture with 2 subtypes. Surgery approach and fixation method depended on the type of fracture. All patients returned regularly to complete a physical examination, radiographs, and American Orthopedic Foot and An-kle Society (AOFAS) ankle/hind foot questionnaires and visual analogue scale (VAS). Results All patients were followed-up with a mean period of 18.2 months. According to the Burwell-Charnley radiological evaluation system, 10 cases had obtained anatomic reduction, 7 cases fair reduction and only 1 case poor reduction. The mean AOFAS sore was 82.5 and the mean VAS scores during weight-bearing walking was 1.6, respectively. Conclusion The posterior pilon fracture has unique features that fractures of the posterior malleolus extend into the posterior colliculus of the medial malleolus. The AGH classification system is worthy of popu-larization and application in clinics, and it is reliable and instructive in the treatment of posterior pilon fractures. Key words: Ankle joint; Fractures, bone; Dislocations