The outcome of pilon fracture management using different fixation modalities

Abstract

Background: treatment of pilon fractures is challenging and the appropriate method is still uncertain. Purpose: detection of the best modality for the treatment of pilon fractures. Patients and Methods: This prospective study was conducted on 40 patients with pilon fractures. The patients were subdivided into 3 groups; Group A: 12 patients underwent temporary DFF followed by later ORIF, and Group B: 8 patients underwent fixation with primary IF. Group C: 20 patients underwent fixation with Primary ORIF. Results : The adequacy of anatomical reduction was significantly higher in group C than in groups A and B. The union rate was 97.5%. In group C, 1 (5%) case of late postoperative infection, 2 (10%) cases of skin breakdown, and 5 (25%) cases of ankle stiffness. AOFAS was significantly excellent in group C than in group A with no significant difference between groups A, B, and B, C. Conclusion: using the primary Ilizarov fixator is the best treatment for all open and closed type RA III pilon fractures. It is more successful than primary ORIF surgery. primary ORIF is the ideal option for closed pilon fracture RA I and II with mild oedema. Using temporary DFF followed by later ORIF is reliable technique for open fracture RA I and III.