Analysis Of Surgical Efficacy Of Posterior Pilon Fracture

Objective To compare and analyze the clinical effects of 2 fixation methods of screw fixation(SF)and buttress plate fixation(BPF)in treatment of posterior Pilon fractures.Methods Data of 28 patients with posterior Pilon fractures from Jan.2013 to Dec.2017 in our hospital was retrospectively analyzed.According to different internal fixation methods,patients were divided into SF group(16 cases)and BPF group(12cases).There was no significant difference in age,gender,injury cause,side,disease duration,and complications among groups(P > 0.05).The operation time and bleeding volume in the two groups were analyzed statistically.Clinical and radiographic examinations were used to assess the reduction and healing of fracture;the American Orthopaedic Foot and Ankle Society(AOFAS)ankle-hindfoot score and the visual analogue scale(VAS)were used to evaluate the functional outcomes.Results A total of 28 cases were followed up 12~52 months(16 in SF group and12 in BPF group),with a mean time of 34.2 months.No breaking or bending was observed in all specimens,fixation failure was caused by cancellous bone compression.All of the cases obtain bony union within 3 to 6 months with no fixation failure.No significant difference of the AOFAS score and the VAS score was found between SF and BPF groups(P > 0.05),But the excellent and good rate of AOFAS score in BPF group was higher than that in SF group(P < 0.05).The data of the operation time and bleeding volume of SF group was better than that of BPF group(P < 0.05).Conclusion For the patients with posterior Pilon fracture,satisfactory clinical results can be achieved by rational clinical evaluation and adequate preoperative preparation,open reduction or internal fixation with screw and buttress plate through the posterior and posterior lateral incision of ankle joint.