Comparison of the Results between Plating and Intramedullary Nailing for Ipsilateral Fibular Fractures in Pilon Fractures

ABSTRACT

Purpose@#To compare the results between plating and intramedullary nailing for ipsilateral fibular fractures in pilon fractures. @*Materials and Methods@#Among 124 patients with pilon fractures from November 2008 to March 2019, 50 patients with a fibular fracture were studied retrospectively and divided into two groupsGroup A using a plate and Group B using a Rush pin. The radiological tests confirmed the fracture pat-terns (Rüedi–Allgöwer classification, AO/OTA classification) and evaluated the degree of reduction of fibular and tibial fractures after surgery. The American Orthopaedic Foot & Ankle Society (AOFAS) was examined for a clinical evaluation, and the complications were checked. @*Results@#The two groups showed similar distributions in gender, age, injury mechanism, diabetes, smoking, mean follow-up period, Rüedi–Allgöwer classification, AO/OTA classification, and open fracture.The fibular fractures were classified as simple, wedge, multiple, and segmental, showing significant differences between the two groups (p=0.03). There was no difference in the Talocrural angle, Shenton line, and Dime sign. In the reduction of pilon fractures, the appropriate reduction was obtained in 22 cases (88.0%) for both groups. The AOFAS averaged 83.24 in Group A and 80.44 points in Group B, showing no significant difference in complications (nonunion, malunion, infection, and arthritis). @*Conclusion@#Regardless of how the fibular fracture was fixed, the reduction of pilon fractures in bothgroups showed good results. Both intramedullary nail and plate fixation could be a suitable fixation method for ipsilateral fibular fractures with a low risk of shortening in pilon fractures.