Arthroscopically Assisted Limited Open Reduction and Ilizarov External Fixation of Tibial Pilon Fractures

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

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Treatment of Tibial Pilon Fractures with Two-Staged Delayed Open Reduction and Internal Fixation

The Journal of the Korean Orthopaedic Association ◽

10.4055/jkoa.2005.40.2.188 ◽

2005 ◽

Vol 40 (2) ◽

pp. 188 ◽

Cited By ~ 1

Author(s):

Hong Moon Sohn ◽

Jun Young Lee ◽

Sang Ho Ha ◽

Sung Min Choi

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Tibial Pilon ◽

Pilon Fractures

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External Fixation of Severely Comminuted and Open Tibial Pilon Fractures

Clinical Orthopaedics and Related Research ◽

10.1097/00003086-199307000-00012 ◽

1993 ◽

Vol 292 ◽

pp. 101-107 ◽

Cited By ~ 167

Author(s):

LAWRENCE BONE ◽

PHILIP STEGEMANN ◽

KEVIN MCNAMARA ◽

ROGER SEIBEL

Keyword(s):

External Fixation ◽

Tibial Pilon ◽

Pilon Fractures

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Emergency Room External Fixation of Tibial Pilon Fractures

Techniques in Foot & Ankle Surgery ◽

10.1097/00132587-200212000-00010 ◽

2002 ◽

Vol 1 (2) ◽

pp. 151-157

Author(s):

JOSEPH A. IZZI ◽

RAHUL BANERJEE ◽

ANDREW H. SMITH ◽

RICHARD L MCGOUGH ◽

CHRISTOPHER W. DIGIOVANNI

Keyword(s):

Emergency Room ◽

External Fixation ◽

Tibial Pilon ◽

Pilon Fractures

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Open Reduction Internal Fixation versus External Fixation with Limited Internal Fixation for Displaced Comminuted Closed Pilon Fractures: A Randomised Prospective Study

Journal of Orthopaedics Trauma and Rehabilitation ◽

10.1016/j.jotr.2017.08.001 ◽

2018 ◽

Vol 24 (1) ◽

pp. 84-89

Author(s):

Rayan Ahmed ◽

Kotb Ahmed ◽

M. Elmoatasem Elhussein ◽

Samir Shady ◽

Tamer A. El-Sobky ◽

...

Keyword(s):

Soft Tissue ◽

Prospective Study ◽

Internal Fixation ◽

External Fixation ◽

Functional Outcomes ◽

Open Reduction ◽

Articular Surface ◽

High Energy ◽

Complication Rates ◽

Pilon Fractures

Background Pilon fractures involve the dome of the distal tibial articular surface. The optimal treatment for high-energy pilon fractures remains controversial. Some authors advocate the use of open reduction and internal fixation (ORIF) to avoid articular incongruence. Others advocate the use of bridging external fixation with limited internal fixation (EFLIF) to reduce soft tissue complications. Literature reports of prospective studies comparing the radioclinical outcomes of ORIF and EFLIF in high-energy fractures are scarce. Retrospective studies have their limitations because of insufficient randomisation. The objective of this randomised prospective study is to compare the clinical, radiologic and functional outcomes of displaced and comminuted closed pilon fractures, Rüedi and Allgöwer type II and III, treated by either ORIF or EFLIF. Materials and Methods Forty-two patients were selected for the study. Twenty-two patients were subjected to ORIF and 20 patients were subjected to EFLIF. We used the American Orthopaedic Foot and Ankle Society score as a standard method of reporting clinical status of the ankle. Patients were followed-up clinically and radiologically for over 2 years after the surgical treatment. Results The results of ORIF and EFLIF in treatment of high-energy pilon fractures are equally effective in terms of functional outcomes and complication rates on the short term. Conclusion Soft tissue integrity and fracture comminution seem to have a significant influence on outcomes of intervention. A prospective multicentre study with a larger sample size that controls for other associated variables and comorbidities is warranted. Level of evidence Level II.

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