Impact of the fibula fractures and syndesmotic injuries on the prognosis of the tibial pilon fractures

To evaluate tibial pilon fractures, as well as the type of fibula fracture, and the presence of injury to the inferior tibiofibular joint. Materials and methods: The study included 42 patients (34 male, 8 female) who underwent surgery for pilon fractures and were followed up. The mean follow-up period of the patients was 72 months (range: 36-102 months). The patients were classified into 2 groups as Ruedi-Allgower (RA) Type II, including 20 patients and RA Type III, including 22 patients. The fibula fractures of the patients were classified according to the Weber classification. The reduction quality was determined by evaluating the early postoperative graphs of the patients based on the scale defined by Conroy et al. The standard anterior-posterior and side graphs were investigated for arthrosis. The clinical evaluation of the ankles of the patients was based on the rating scale of Teeny and Wiss. Results: In the RA Type II group, Weber B fibular fractures were significantly more common and, in the RA Type III group, Weber C fibular fractures were significantly more common (P < 0.001). Comparisons of the fibular fracture types revealed that in Weber Type C fractures, the incidence of posttraumatic arthrosis was higher (P < 0.05). The clinical evaluations recorded on the final controls of the patients showed that sufficient outcome was achieved in 55% of the patients with RA Type II fractures and in 45.5% of the patients with the RA Type III fractures. Conclusion: The type of fibular fracture and the presence of syndesmotic injury affect the functional outcome of pilon fractures.

Impact of the fibula fractures and syndesmotic injuries on the prognosis of the tibial pilon fractures

To evaluate tibial pilon fractures, as well as the type of fibula fracture, and the presence of injury to the inferior tibiofibular joint. Materials and methods: The study included 42 patients (34 male, 8 female) who underwent surgery for pilon fractures and were followed up. The mean follow-up period of the patients was 72 months (range: 36-102 months). The patients were classified into 2 groups as Ruedi-Allgower (RA) Type II, including 20 patients and RA Type III, including 22 patients. The fibula fractures of the patients were classified according to the Weber classification. The reduction quality was determined by evaluating the early postoperative graphs of the patients based on the scale defined by Conroy et al. The standard anterior-posterior and side graphs were investigated for arthrosis. The clinical evaluation of the ankles of the patients was based on the rating scale of Teeny and Wiss. Results: In the RA Type II group, Weber B fibular fractures were significantly more common and, in the RA Type III group, Weber C fibular fractures were significantly more common (P < 0.001). Comparisons of the fibular fracture types revealed that in Weber Type C fractures, the incidence of posttraumatic arthrosis was higher (P < 0.05). The clinical evaluations recorded on the final controls of the patients showed that sufficient outcome was achieved in 55% of the patients with RA Type II fractures and in 45.5% of the patients with the RA Type III fractures. Conclusion: The type of fibular fracture and the presence of syndesmotic injury affect the functional outcome of pilon fractures.

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  • 1. Ruedi T, Matter P, Allgower M. Intra-articular fractures of the distal tibial end. Helv Chir Acta 1968; 35: 556-582.
  • 2. Muller ME, Nazarian S, Koch P, Schatzker J. Th e Comprehensive Classifi cation of Fractures of Long Bones. Berlin: SpringerVerlag; 1990; 170-172.
  • 3. Schatzker J, Tile M. Tibial pilon fractures. In: Schatzker J, Tile M, editors. Rationale of Operative Fracture Care. 2nd ed. Berlin: Springer-Verlag; 1996; 491-523.
  • 4. Barei DP, Nork ES, Bellabarba C, Sangeorzan BJ. Is the absence of an ipsilateral fi bular fracture predictive of increased radiographic tibial pilon fracture severity? J Orthop Trauma 2006; 20: 6-10.
  • 5. Conroy J, Agarwal M, Giannoudis PV, Matthews SJ. Early internal fi xation and soft tissue cover of severe open tibial pilon fractures. Int Orthop 2003; 27: 343-347.
  • 6. Teeny SM, Wiss DA. Open reduction and internal fi xation of tibial plafond fractures. Clin Orthop 1993; 292: 108-117.
  • 7. Martin JS, Marsh JL, Bonar SK, DeCoster TA, Found EM, Brandser EA. Assessment of the AO/ASIF fracture classifi cation for the distal tibia. J Orthop Trauma 1997; 11: 477- 483.
  • 8. Ayeni JP. Pilon fractures of the tibia: a study based on 19 cases. Injury. 1988; 19: 109-114.
  • 9. Leung F, Kwok HY, Pun TS, Chow SP. Limited open reduction and Ilizarov external fi xation in the treatment of distal tibial fractures. Injury 2004; 35: 278-283.
  • 10. Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma 2004; 18(8 suppl): 32-38.
  • 11. Ruedi TP, Allgower M. Fractures of the lower end of the tibia into the ankle joint. Injury 1969; 1: 92-99.
  • 12. Kalender O, Gunes O, Ozcalabi T, Ozluk S. Clinical results of tibial pilon fractures treated by open reduction and internal fi xation. Acta Orthop Traumatol Turc 2003; 37: 133-137.
  • 13. Borrelli J Jr, Ellis E. Pilon fractures: assessment and treatment. Orthop Clin North Am 2002; 33: 231-45.
  • 14. Ovadia DN, Beals RK. Fractures of the tibial plafond. J Bone Joint Surg Am 1986; 68: 543-51.
  • 15. Bourne RB. Pylon fractures of the distal tibia. Clin Orthop 1989; 240: 42-6.
  • 16. Sirkin M, Sanders R. Th e treatment of pilon fractures. Orthop Clin North Am 2001; 32: 91-102.
  • 17. Koulouvaris P, Stafylas K, Mitsi onis G, Vekris M, Mavrodontidis A, Xenakis T. Long-term results of various therapy concepts in severe pilon fractures. Arch Orthop Trauma Surg 2007; 127: 313-320.
  • 18. Tarkin IS, Clare MP, Marcantonio A, Pape HC. An update on the management of high-energy pilon fractures. Injury 2008; 39: 142-54.
Turkish Journal of Medical Sciences-Cover
  • ISSN: 1300-0144
  • Yayın Aralığı: Yılda 6 Sayı
  • Yayıncı: TÜBİTAK
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Impact of the fibula fractures and syndesmotic injuries on the prognosis of the tibial pilon fractures

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