Open reduction and internal fixation of posterior pilon fractures with buttress plate

Abstract

Objective: Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate. Method: In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score). Results: Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively. Conclusion: Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study.

Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study

“…Ten patients with PPFs treated with BPs by Chen achieved satisfactory clinical results during an average follow-up of 36.2 months. [15] Sukur [3] treated 14 cases of PPF; 3 cases were fixed with BPs, and 11 cases were fixed with PASs. All patients exhibited satisfactory reduction, and Sukur therefore believed that PASs can also stabilize PPF fixation.…”

“…The above methods have advantages and disadvantages, and a consensus on the best method has not yet been reached. [12][13][14][15] The purpose of this study was to evaluate whether BPs and APSs can effectively reduce and fix PPFs and to compare the clinical efficacy and postoperative complications of these two internal fixation methods.…”

Comparison between buttress plate and anteroposterior screw internal fixation for posterior pilon fracture: a retrospective study

“…Ten patients with PPFs treated with BPs by Chen achieved satisfactory clinical results during an average follow-up of 36.2 months. [15] Sukur [3] treated 14 cases of PPF; 3 cases were xed with BPs, and 11 cases were xed with PASs. All patients exhibited satisfactory reduction, and Sukur therefore believed that PASs can also stabilize PPF xation.…”

“…[10,11] In 2013, Klammer [12] has not yet been reached. [12][13][14][15] The purpose of this study was to evaluate whether BPs and APSs can effectively reduce and x PPFs and to compare the clinical e cacy and postoperative complications of these two internal xation methods.…”

Open reduction and Internal Fixation (ORIF) of Posterior Pilon Variant Fractures with Buttress Plate Through Posterolateral Approach

“…14 It was found that just as in classic pilon fractures, it required 8 days for a soft tissue resolution as seen in the study conducted by Chen's, YuKai wang's et al which also found that posterior pilon variant is not from high energy trauma that requires staged management in pilon fracture. 15,16 Besides, the coronal fracture lines found in posterior pilon variant was different from sagittal fracture lines in high energy pilon fracture described in the study done by Topliss et al 17 On the contrary, the fracture lines were consistent with the fracture map of posterior malleolus and what's more, unlike malleolar fracture caused by low energy torsional force, the independent PM fracture in posterior pilon variant not only extends proximally but also often involves posterior colliculus of medial malleolus which is 12 out of 16 in this study. 16 Posterolateral approach in prone position which was initially designed for posterior malleolus fracture is the most accepted surgical approach to posterior pilon variant at present.…”