Comparison Of Three Kind Of Methods In Treatment Of Severe Pilon Fracture

Objective: Heavy energetic pilon fracture of tibial is not so common inorthopaedics clinic, and it is notori-ously difficult to treat. This thesisdiscusses and studies the choice of fixation methods, prevention and curecomplications. We evaluate and compare severe pilon fracture cases curedwith three different fixation methods. Those methods are the open reductionand internal fixation, the two-laded delayed open reduction and internalfixation, and the limited open reduction and internal fixation with externalfixation. This thesis makes a theoretical analysis to offer a basis on choosingthe proper treatment method in clinic.Methods: We retrospectively reviewed the clinical reco-rds of 36 patientswith severe pilon fracture for three kinds of different treatment; ORIFgroup(8cases), two-laded delayed group(12cases), and limited ORIF withexternal fixation group(16cases) from Jan 2000 to Sep 2006. All thesepatients were followed up for 6 to 50 months with an average of 22months.To compare and analyse how the curative effects severe pilon fracturefor three kinds of different treatment methods from the average hospital stays, the incidence of complications, the functional evaluation of anklejoint (the rate of excellent and good results).Results: The average hospital stays were 16.32 days for the ORIFgroup,25.25 days for the two-laded delayed ORIF group,and 15.25 days forthe limited ORIF with external fixation group. The incidence of postop andanaphase complications were 37.5ï¼…and 25ï¼…for the ORIF group, 16.7ï¼…and16.7ï¼…for the two-laded delayed ORIF group,while 12.5ï¼…and 25ï¼…for thelimited ORIF with external fixation group. There were significantdiffer-ence among the three groups in the incidence of postopcomplications, but no significant difference in the incidence of anaphasecomplications. While according to the Mazur's ankle functional standardscore, the rate of excellent and good results for each group were 62.5ï¼…,66.7ï¼…and 62.5ï¼…. There were no significant difference among the threegroups.Conclusion: The treatment protocols of ORIF and limited open reductionand internal fixation with external fixation are appropriate treatments ofsevere Pilon fractures after trauma, especially the limited ORIF with externalfixation is a effective fixation methods of curing pilon fracture for thepatient of severe softtissue loss or damage. It could raise cure rate and degradecomplication.