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KMID : 0896719970010020102
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Journal of the Korean Society of Foot Surgery
1997 Volume.1 No. 2 p.102 ~ p.111
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Limited Open Reduction and Internal Fixation of the Tibial Pilon Fractures
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Kang Chung-Nam
Kim Jong-Oh
Yoo Jae-Doo
Kim Dong-Wook
Koh Young-Do
Ko Sang-Hun
Hwang Jun-Ho
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Abstract
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The tibial Pilnn fracture, which is defined as a comminut.ed intraarticular fracture of the distal tibia, is difficult to manage hecause high axial compressian and rotationaJ forces to the ankle joint result. in impaction, severe comminution, metaphyseal disruption and soft tissue damage. There are variable methods of treatment. such as manipulation and cast, calcaneal traction and cast, external fixation, pin and plaster, lirnited open reciuction and ext.ernal fixation, and open reduct.ion and rigid internal fixat.ion. Though most of authors reported better result. after a surgical treatment. than t.hat, of conservative treatment, many complications such as post.traumatir arthritis anci soft. tisse problern slill remairi troublesome. We have reviewed 19 cases of the tibial Pilon fractures in 18 patierit.s which were treatecl with limited open reduct.ion and internal fixation frorn Septemher 1993 to May 1996. The results were as follows : 1. The fractures were classified into five types according to the system of Ovadia and Beals, and the most frequent type was type 3 (53%). The most. common cause of injury was traffic accident (47%). 2. All of the cases of type 1 and 2, in which the injury of the ankle joint was less severe, revealed good or excellent. clinical results. But in type 4 and 5, hecause the injury is much severe and accurate reduciion is difiicult, the clinical results were unsatisfotory. 3. The most frequennt complication was posttraumatic ostenart.hritis, and which developed in
second frequent. camplication, was developeed in the three cases of type 3 in which the radiographic results were less than fair, but there were no correlation with the clinical results. 4. We cauld markedly reduce the complications related to the soft tissue problem of Pilon fracture by treatment with lirnited open reduction and int.ernal fixation, and cansider that this is a gaod method of treatment of Pilon fracture when the injury is less severe and accurate eduction is possible.
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KEYWORD
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Tibia, Pilon fracture, Operative treatment
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