Ilizarov Treatment of Pilon Fractures

“…They favoured limited percutaneous fixation techniques in association with external fixation devices for these fractures. 9,14 In the same year Bone et al observed that the improved outcome of ORIF method seen in the study of Ruedi and Allgower was due to the low energy nature of most pilon fractures in that series, but similar encouraging results were not seen in high energy pilon fractures. They recommended the use of fibular platting with ankle spanning external fixator with or without minimal internal fixation.…”

Section: Discussionmentioning

confidence: 93%

“…[4][5][6][7] These fractures are often due to serious high energy trauma resulting in gross communition of the articular surface as well as the distal tibial metaphysis. 4,6,8,9 The associated soft tissue injury around ankle makes the matters more serious due to high incidence of skin and surgical site complications. 10 Various techniques of surgical and non-surgical treatment have been advocated by different researchers across the decades with more and more variable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Operative outcome of high energy pilon fractures: a retrospective comparison between internal fixation and Ilizarov external fixation

et al. 2017

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Background: Pilon fractures are serious injuries with many devastating soft-tissue complications associated with them. Deciding a definite treatment plan has always proved a challenge. Comparative studies between the various surgical techniques used for pilon fractures are uncommon and consensus is yet to be reached regarding the best surgical option. Purpose of this study is to retrospectively compare the operative results (complications, functional and radiographic outcomes) of pilon fractures treated either with internal fixation or Ilizarov ring fixators.Methods: Forty-six patients with pilon fractures were retrospectively studied; twenty-one of them had minimal invasive fixation by ankle spanning Ilizarov fixators and 25 patients had internal fixations by either minimal invasive plate osteosynthesis (MIPO) or by open reduction. The patients were followed-up for a mean of 34 months (range, 24-51 months).Results: The internal fixation group had a higher incidence of soft-tissue complications and deep infections. In comparison the Ilizarov group had only superficial pin-tract infections but no other soft-tissue complications. Although the Ilizarov group had a higher incidence of malreduction and malunion in their series compared to the internal fixation group, there was no significant difference in the AOFAS ankle function score (p-value 0.2922) between the two groups after a follow-up of 2-4 years.Conclusions: The moderately long term functional outcome appears to be similar in both internal fixation and Ilizarov groups. But the Ilizarov technique is less likely to cause any serious peri-operative soft-tissue complications or deep infection. Familiarity of the surgeon with a particular technique should also be considered during surgical decision making.

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“…3 Early mobilisation of the ankle joint is another advantage of the Ilizarov device. 20,21 In fractures caused by axial…”

Section: Discussionmentioning

confidence: 99%