Treatment Of Pilon Fracture By Limited Open Reduction Of Locking Plates

Objective: To treat pilon fractures of tibial has always been challenge the orthopaedic surgeon. Due to the less soft tissues covering and blood supply of the tibial, the surgical treatment is more complex. The purpose of this study is comparing between traditional open reduction and internal fixation with anatomical steel plate and limited open reduction locking plate internal fixation treatment in the clinical curative effect of pilon fractures, then discuss the clinical effect of limited open reduction locking plate treatment in the pilon fractures.Methods: From Aug, 2007 to Sep, 2010, the study involved 40 subjects diagnosed with fracture of tibial pilon and treatment in the Orthopaedics Depart. of the Affilitated hospital of Yan'an Uniersity , then get follow-up of all patients ;Randomly divided into two groups, (group A) as the group which using traditional open reduction treatment with anatomical steel plate, (group B) as another group by means of limited open reduction locking plate therapy. We compared and analyzed the result of treatment, complications and Mazur ankle function score between the two groups.Results: According to the Ruedi and Allgower classification method the subjects classified intoâ… type,â…¡type,â…¢type. There was no significant difference obtained between the two groups (P > 0.05). There is no statsitics difference between the two groups in the fracture degree, So both two groups are comparable. All patients were followed up, get a average follow-up about 15 months (6 to 24 months). According to Mazur ankle function scoring system , the excellent and good rate of group A was 75% ,and the excellent and good rate of group B was 90%, there is no significant differences between groups. Taking wound infection and skin necrosis into consideration: 5 cases in group A, 0 cases in the group B, there is significant differences detect between-group. With respect to Fracture delayed union or nonunion: 6 cases in group A , 1 case in group B, the difference between A and B group was also significant. stiff joints: 4 cases in group A, 1 case in group B, there is no significant difference obtained between groups.Conclusion: The treatment of pilon fractures by limited open reduction of locking plates can better recovery ankle function, and reduce the complications. We can obtain satisfactory clinical curative effect, so it is a good method for the treatment of tibial pilon fractures.