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Comparsion of treatment methods and complitacions in pilon fractures of the tibia


Authors: Jan Trávník;  Libor Paša;  Josef Prokeš;  Radek Veselý
Authors‘ workplace: Emergency Hospital Brno, Department of trauma surgery, Medical Faculty Masaryk University Brno, Czech Republic ;  Úrazová nemocnice v Brně, Klinika traumatologie, Masarykova univerzita, Brno
Published in: Úraz chir. 24., 2016, č.3

Overview

Background:
Pilon fractures (Tibial plafond) are frequent and serious injuries. Pacients are treated long time and it causes them both medical and social complications. Goal of pilon fracture treatment is to restore the joint surface either by external fixator or plate.

Study goals:
Comparison of treatment methods of pilon fracture and review of their complications is the principal goal of this study. Results of this study were compared with other recent articles.

Methods:
A retrospective study took place in Emergency Hospital Brno, Department of trauma surgery, Masaryk University. Patients with tibial plafond AO B3, C1 – C3 fractures were involved in the study. They were diveded into two comparable groups. One group was treated by external frame, whereas the other one was treated by LCP plate system. Division was made upon the choice of surgeon in coordinance with type of fracture, soft tissue quality and other external factors. Treatment follow up, Webber clinical evaluation and treatment complications were compared between these two groups.

Results:
Together 67 patients were included in the study, 32 of them treated by LCP plate and 35 with external fixator. All fractures has healed and all patients were able to bear full weight during the 18 month follow-up period. 4 cases of delayed union were seen in the fixator group. Where as in LCP plate group were 4 patients with skin infection.

Conclusion:
Higher incidence of delayed union in the fixator group and tissue infection in the LCP plate group were observed. Despite these results there was no l difference in the clinica outcome between both groups at the end of the 18 month follow-up period. Our results are consistent with conclusions of other authors.

Key words:
Tibial plafond fracture, pilon fracture, external fixator, LCP plate, complications, infection.


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