Surgical treatment of high-energy type II/III Pilon fracture

Objective To evaluate the surgery timing and management protocol for high-energy Pilon fracture,and to determine whether long-term results of one of different management protocols for severe tibial Pilon fractures offer advantages over the other.Methods In a retrospective study,46 patients with high-energy type Ⅱ/ Ⅲ Pilon fracture were treated with limited open reduction and external fixation group and open reduction internal fixation with locking compression plate(LCP) +bone grafting group.We evaluated the clinical outcomes according to the rating scale of the modified Mazure score system.Results All patients were followed up at an average of 25.8 months(range 8 to 36 months)after surgery.According to Mazur function assessment system,the curative effect was excellent in 27 patients,good in 10,fair in 36 and poor in 3.The excellent and good rate was 80.4%.The rate in the external fixation group was 70.6%,and 82.8% in the LCP open reduction and internal fixation group.There was no statistically significant difference between the three groups(P0.05).Conclusion Both the two operational methods for the treatment of high-energy type II / III Pilon fracture have good effect.In terms of postoperative soft tissue complications and clinical observation of fracture reconstruction quality,open reduction internal fixation with locking compression plate(LCP) +bone grafting group is superior to the limited open reduction and external fixation group.