Minimally invasive treatment of pilon fracture with single main plate combined with multiple planar screws for supporting fixation / 中华骨科杂志

ABSTRACT

Objective To explore the clinical effect of minimally invasive treatment of C type pilon fracture with single main plate combined with multiple planar screws for supporting fixation.Methods From January 2013 to March 2017,data of 22 patients treated by minimally invasive treatment with single main plate combined with multiple planar screws for supporting fixation were retrospectively analyzed.There were 17 males and 5 females,aged from 23 to 69 years (average,51.2 years).All cases were closed fractures involving fibula including weight hitting (5 cases),traffic accident (7 cases) and fall injury (10 cases).There were 3 cases of 43-C1 type,11 cases of 43-C2 type and 8 cases of 43-C3 type according to AO/OTA classification.According to the Rtiedi-Allg(o)wer classification,there were 5 cases of type Ⅱ and 17 cases of type Ⅲ.Complications were recorded postoperatively and the articular surface reduction was evaluated using the Burwell-Charnley score.At the last follow-up,Tornetta's pilon fracture clinical treatment outcome criteria was used to evaluate ankle joint function.Results All the patients were followed up for 13 to 25 months (average,17.3 months).There were 20 cases of anatomical reduction,1 case of fair reduction and 1 case of poor reduction according to the Burwell-Charnley score.All the 22 patients were healed with healing time of 3 to 6 months (average,4.8 months).The efficacy was evaluated according to the evaluation criteria of the clinical treatment results of pilon fracture by Tornettaexcellent in 8 cases,good in 10 cases,fair in 3 cases,and poor in 1 case.The excellent and good rate was 81.8％(18/22).All patients had no complications such as wound edge blistering,skin necrosis and infection.Among them,1 case of internal fixation rejection occurred,and the incision was well healed after removal of the internal fixation after 3 months.Conclusion Minimally invasive treatment of C type pilon fracture with single main plate combined with multiple planar screws for supporting fixation not only provides a better anatomical reduction of the articular surface,but also effectively reduces or even avoids incision complications.The long-term clinical results are satisfactory.