Correlation of tibial and fibular fractures in Pilon fractures

doi:10.12307/2024.084

Abstract

Abstract: BACKGROUND: The Pilon fracture has a complex fracture line and a comminuted fracture fragment. It is often associated with bone loss and soft tissue damage and is one of the most difficult fractures to treat clinically.
OBJECTIVE: To analyze the correlation between tibial and fibular fractures in Pilon fractures.
METHODS: A retrospective analysis was conducted on 188 patients with Pilon fracture in the Department of Trauma Orthopedics, The Second People’s Hospital of Lianyungang City from January 2014 to January 2022. Imaging data of these patients were collected. Fibular fracture level, fibular fracture type, number of fibular fracture blocks, tibial position status, main fracture blocks of the tibia, size of medial fracture blocks of the tibia, tibial fracture angle, Topliss classification (sagittal plane) and Topliss classification (coronal plane) were summarized into a database. SPSS 25.0 was used to analyze the data of tibia and fibula in Pilon fractures by Spearman correlation analysis. On the basis of the correlation, multiple disordered Logistic regression was used to further analyze the correlation.
RESULTS AND CONCLUSION: (1) Spearman correlation analysis showed that tibial fracture angle was positively correlated with fibular fracture type, fibular fracture level and fibular fracture number. Tibial position status was positively correlated with tibial fracture angle and Topliss classification (coronal plane), but negatively correlated with major tibial fracture blocks and Topliss classification (sagittal plane). The level of fibular fracture was positively correlated with the type of fibular fracture and the number of fibular fractures. The main fracture blocks of the tibia were positively correlated with Topliss classification (coronal plane) and negatively correlated with Topliss classification (sagittal plane). (2) Multiple Logistic regression analysis showed that: the level of fibular fracture was correlated with the type of fibular fracture (P < 0.05); the number of fibular fractures was correlated with the main fracture block of tibia (P < 0.05). (3) It is indicated that the more inclined the ankle joint was to the valgus, the more likely it was to lead to fibular fracture, and the higher the fibular fracture level, the more serious the fibular fracture degree, the more complex the fibular fracture type, the larger the tibial fracture angle, the more the tibia presented Topliss classification (coronal plane) fracture. (4) When the ankle joint was more inclined to be in varus or varus + dorsiflexion, the fibula often did not fracture or simple fracture occurred, and the lower the fracture level, the smaller the tibial fracture angle, the more Topliss classification of the tibia (sagittal plane), the more main fracture blocks of the tibia, the larger the medial fracture block. When the ankle joint is in the dorsiflexion, it often results in a simple fibular fracture with a posterolateral tibial fracture.

Key words: Pilon fracture, tibial fracture, fibular fracture, fracture classification, correlation

CLC Number:

Xu Shizhuang, Chen Hongquan, Hou Jianwen, Sun Kefu. Correlation of tibial and fibular fractures in Pilon fractures[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(21): 3355-3360.

Figures/Tables 4

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