Treatment of Tibial Pilon Fractures with Minimal Open Reductio n
and Circular Ring External Fixation |
Treatment of Tibial Pilon Fractures with Minimal Open Reduction and Circular Ring External Fixation |
Ki Cheor Bae; Kwang Soon Song |
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Abstract |
The purpose of this thesis was to evaluate effectiveness of minimal open reduction and circular
ring external fixation for treating of tibial pilon fractures with serious soft-tissue injuries or open
wounds. The retrospective outcome study was performed as one of the methodology to conduct
this research. The study was conducted on fifteen patients with tibial pilon fractures associated
with serious soft-tissue injuries or open wounds. Patients were treated with minimal open
reduction and circular ring external fixation and all of them were monitored for more than one
year. Out of fifteen patients; thirteen of them were males and two were females; and their mean
age was 45.3 years old (ranging from 29 to 62). Reduction status was evaluated with radiology
based on the Burwell and Charnley’s criteria. Ankle function was graded using the criteria
suggested by Mast and Teipner. The length of time that the circular ring external fixation device
remained in place varied for each patient according to time until bony union. Any other
complications were recorded throughout the study. Bony union was achieved within average 17.2
weeks in 13 out 15 fracture (86.6%). For 2 fractures complicated by infection; bony union was
achieved at an average of 37 weeks after eradication of the infection. During the final follow-up
examination; radiographs revealed that 7 patients had anatomic reduction; 6 had fair reduction;
and 2 had poor reduction. Clinically; 7 patients had good function; 4 had fair function; and 4 had
poor function. Range of motion of ankle joint at last follow up. Showed average 17 degree of
dorsiflexion and 13 degree of plantarflexion. There were 3 types of complications found during
the study: pin-tract infection (1 patient); osteomyelitis (1 patient); and posttraumatic arthritis (1
patient). In conclusion; the combination of minimal open reduction and circular ring external
fixation could be considered as an alternative treatment for tibial pilon fracture associated with
serious soft-tissue injuries or open wounds. |
Key Words:
Circular ring external fixation, Minimal open reduction,
Pilon fracture, Tibia |