Comparative study of open reduction and internal fixation versus external fixation combined with limited internal fixation in the treatment of Pilon fractures

Objective To compare the efficacy of open reduction and internal fixation versus external fixation combined with limited internal fixation in the treatment of Pilon fractures.Methods 76 patients with Pilon fractures confirmed by X-ray or CT were divided into study group(n = 38,received external fixation combined with limited internal fixation) and control group(n = 38,received open reduction and internal fixation) at random,the fracture healing time,postoperative ankle joint function recovery and complications of the two groups were compared.Results The mean fracture healing time of study group was(5.9±0.6) months,slightly longer than control group of(5.2±0.4) months,but no statistical difference was observed(P 0.05).The ankle joint function of both groups was well recovered,but the good rate of study group(84.21%) was significantly higher than control group(68.42%)(P 0.05).The complication incidence of study group was 15.79%(6/38),which was statistically higher than control group [28.95%(11/38)](P 0.05),and the incidence of soft tissue infection was higher than control group(P 0.05),the incidences of osteomyelitis and malunion were lower than control group(P 0.05),and the incidences of joint fusion were equal in two groups(P 0.05).Conclusion External fixation combined with limited internal fixation is simple and safe with less complications in treating Pilon fractures,and it can obtain good ankle joint function prognosis,thus it is worthy of extensive applied in clinic.