Retrospective Analysis To The Curative Effect Of Comminuted Pilon Fracture With Different Surgical Option And Different Degree Of Operative Reduction

Objectives: The therapeutic effect of the treatment of pilon fracture, in minimallyinvasive locking plate fixation and traditional open reduction locking plate fixation,with the different degree of the operative reduction, is analysed and compared in thispaper, for providing the theoretical reference of the treatment of pilon fracture.Methods: It is a retrospective analysis about49cases of patients who have been gotpilon fracture as type III(or AO C3)and were treated with minimally invasive lockingplate fixation by using MIPPO technique (group1), or with open reduction and lockingplate fixation (group2) as the research object in our hospital between January2007-January2012. In the research,19cases of them are male,20cases of them are female.Their ages are23-67years old, on the average of41.8.20cases of them are hurt byfalling accidents from high place,28cases by traffic accidents and1case by sprain.Among them,32cases are closed fracture,17cases are open facture. Through thereview and follow-up, according to the degree of operative reduction of articularsurface, which have been surveyed during the operation and by X ray after theoperation, divide each group into two groups. A means that does reach or close toanatomical reduction, and B doesn’t. Record the time of the operations, earlypostoperative incidence of complications, function of ankle, to compare by statisticalanalysis.Results: The comparation of the time of the operations between group A and B, A1and B1, does no statistical significance because of p>0.05. The comparation of earlypostoperative incidence of complications between group1and2has statisticalsignificance because of p<0.05. The comparation of the subjective function andobjective function of ankle between group A and B have statistical significance because of both of them p<0.05. The comparation of the function of ankle betweengroup1and2does no statistical significance because of p>0.05, and the same to groupA1and A2.Conclusions: During the process of treating comminuted pilon fracture, anatomicalreduction of articular surface is the key to the further curative effect. The theory namedAO and BO are both principle of treating fracture in academia. Minimally invasivelocking plate fixation leads to less early postoperative complications, sizes up to thetheory of BO, and benefits the fracture healing. Whatsoever we take as the surgicaloption, we must do at the right time (ensure the vitality of soft tissues) and improve thereduction of articular surface to get the better ankle function.