Abstract:

BACKGROUND: The difficulty of Pilon fractures with open reduction and internal fixation is the reconstruction of the articular surface and soft tissue protection, compared with the ordinary fixation material, the anatomy type steel plate and lock plate have the advantage of three-dimensional fixation.
OBJECTIVE: To investigate the structural characteristics of anatomical plate and lock plate as well as the curative effect on anatomical reduction of the articular surface of the distal tibial Pilon fractures.
METHODS: Retrospective study was performed on 79 Pilon fracture cases from March 2004 to August 2010, including 22 cases of open injury, 57 cases of blunt trauma, 31 cases of Ruedi-Allgower type Ⅱ and 48 cases of Ruedi-Allgower type Ⅲ; partly open injured patients were operated urgently, the blunt trauma patients accepted open reduction and internal fixation at 7 to 12 days after injury. According to the different fracture morphology and soft tissue injury, open reduction internal fixation, lock plate fixation and tibia external fixation treatment were performed respectively. 
RESULTS AND CONCLUSION: All the patients obtained the 4-9 months follow-up and the treatment effects were evaluated by Tornetta scoring system, 97% excellent and good rate in Ruedi-Allgower type Ⅱ, and 79% in type Ⅲ. Patients of type Ⅲ accepted open reduction internal fixation surgery reached 88% good rate. The frame external fixation patients were dissatisfied with the function recovery. For the patients with external fixation, some skins were superficial infected and the soft tissue was necrosis, and all the infection patients were recovered after treatment, and there were no osteomyelitis and nonunion appeared. To treat Pilon fracture with anatomy type steel plate or lock plate has an ideal effect, the main points of the treatment is to retain the soft tissue coverage and to reconstruct a stable articular surface.