RESUMO
AIM: The aim of the present study is to emphasize the optimal moment and approach for tibial pilon complex fractures and their complications. MATERIAL AND METHODS: We have investigated and treated 7 patients with complex fractures of the tibial pilon with tendencies to complications. According to AO classification,we have recorded 4 fractures type 43C2 AO, 2 fractures type 43C3 AO (with one open fracture type IIIA Gustilo) and 1 fracture type 43B3 AO. According to soft tissue status, surgical treatment was performed by a one-step or two-step approach. RESULTS: All fractures healed after an interval of 13.6 weeks(range 8-28 weeks) with one delayed consolidation. The open fracture was complicated by posttraumatic arthrosis. No infections or implant failures were recorded. According toOvadia score, objective and subjective evolution showed good results in 5 cases, one excellent result and one poor result. CONCLUSIONS: Fracture type and the soft tissue status are crucial for the results of operated fractures. These arguments determine the application of one-step or two-step surgical procedure as well as optimal implant choice.
