International Journal of Orthopaedics Sciences

Prospective and retrospective study of managing tibial pilon fractures using various modalities of treatment

2020, Volume 6 Issue 4

Prospective and retrospective study of managing tibial pilon fractures using various modalities of treatment

Author(s): Dr. Prabhu S, Dr. Neelakrishnan R, Dr. Barathiselvan V, Dr. Balamurugavel PS, Dr. Parasuraman and Dr. Ravikrishna R
Abstract: Aim: Tibial pilon fracture is always a challenge to treat, because of limited soft tissues, the subcutaneous location and poor vascularity. It is a controversial subject despite advances in implants and operative techniques. The goal is to realign the fracture, restoring articular surface, realign limb length and early functional recovery. The aim of our study is to assess the outcome of management of high energy tibial pilon fracture with various modalities of treatment.
Materials and Methods: It was a prospective and retrospective study conducted after ethical committee approval. Patient in age group of > 18 yrs with distal tibial fracture of Ruedi and Allgower type - I, II, III were included in this study. patients associated with vascular and neurology injury were excluded. Functional results were analysed.
Results: The total number of patients included in this study was 25 with age range between 20-64 with a mean age of 32.8 yrs. We had a minimum follow up of 1 yr and maximum follow up of 2 yrs. The union was achieved with a mean time of 12-16 wks. The mean duration from hospital admission to definite surgery was around 10-14 days. Anatomical reduction was achieved in about 14 cases with good alignment.
Conclusion: Tibial pilon fractures are complex injury that are difficult to treat. The combination of articular cartilage injury, Metaphyseal Comminution and soft tissue insult has often resulted in poor outcomes. Respect the soft tissue envelope is the first step in minimizing complications. Internal fixation can be considered as a reliable modality of management of distal tibial fracture and it has to be done either within 24 hrs of injury before the edema sets in or a delay of 8 to 12 days for the edema to settle down and wait for the wrinkle sign to appear, for such cases, external application is preferable. Do not Operate too early through compromised skin, instead wait till the soft tissues is amenable for surgery. Good functional result depends on reasonable anatomical reduction of the articular surface. For all pilon fractures, no single method of fixation is ideal. Choice of surgery depends on fracture pattern, soft tissue injury, patients profile and surgical expertise.
Pages: 554-561  |  652 Views  97 Downloads
How to cite this article:
Dr. Prabhu S, Dr. Neelakrishnan R, Dr. Barathiselvan V, Dr. Balamurugavel PS, Dr. Parasuraman, Dr. Ravikrishna R. Prospective and retrospective study of managing tibial pilon fractures using various modalities of treatment. Int J Orthop Sci 2020;6(4):554-561. DOI: 10.22271/ortho.2020.v6.i4h.2388
 
International Journal of Orthopaedics Sciences
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