Management of tibial plafond fractures with ilizarov external fixator

ABSTRACT

Eighteen tibial plafond fractures in eighteen patients were treated with the Ilizarov external fixator. Twelve patients [66.7%] were males and six [33.3%] were females, and the average age was 36.5 years [range, 23 to 52 years]. The mechanism of injury included thirteen motor-vehicle accidents [72.2%] and five falls from a height [27.8%]. Eleven fractures [61%] were closed and seven [39%] were open [five grade, and two grade]. The fractures were classified according to AO classification system. There were four type Al, three type A2, three type B2, four type C2, and four type C3 fractures. Associated injuries occurred in 6 patients [33.3%] and included an abdominal injury [2 patient], a second long bone fracture [3 patients], and a proximal fracture in the same tibia [one patient]. Open reduction and internal fixation of the fibula fracture was performed in 8 patients [44.5%] using a tubular plate. The ankle joint was crossed with a hindfoot half ring in the type C fractures [44.5%]. Minimal internal fixation with interfragmentary screws was performed in 6 fractures [33.3%]. The average follow-up was 30.5 months [range 24 to 36 months]. All fractures united. The average time of healing was 4.5 months [range, 2.5-6 months]. Seven fractures [39%] were excellent, five [27.8%] good, three [16.6%] fair, and three [16.6%] poor according to the functional ankle score. Pin track infection occurred in four patients [22.2%]. Minimal skin necrosis around the wound was observed in two patients [11%]. Malunion in the form of 15° valgus occurred in one fracture [5.5%].Two patients [11%] had shortening of their legs ranging between 1 to 2 cm