European Journal of Molecular & Clinical Medicine

Abstract

Background:Pilon fractures remain one of the most substantial therapeutic challenges that
confront the trauma surgeon. Numerous features are responsible for this. The use of external
fixation, instead of fixation with a plate,and use of ilizarov decreases the prevalence of early
complications.
Aim of work:To evaluate the efficacy of using ilizarov external fixator in treating pilon
fractures regarding fracture union, clinical outcome and rate of complications.
Patients and methods:Twenty four pilon fracture patients were incorporated in a prospective
study.The fractures have been treated with the Ilizarov apparatus. 3 or 4 rings were used
according to the fracture type. Pre- and post-operatively conventional radiographs, postoperative
pain assessment and complications were evaluated. Pain assessment after operation,
radiology, definitive outcomes and complications post-operation were performed, the follow up
were done after 6 months.Clinical outcomes were evaluated according to the ankle-hindfoot
score devised by the American Orthopaedic Foot and Ankle Society (AOFAS).
Results:No patient developed compartment syndrome or deep venous thrombosis. Pin infections
were frequent, but they were mostly superficial and were treated with antibiotics and local
antiseptics.2 cases of malunion occurred, one of them required ankle fusion. Another patient
had a severe residual deformity. One case experienced delayed union and was treated with
dynamisation of ilizarov frame, otherwise all fractures united and the fixator was removed after
a mean of 20 weeks (range 12–28). The clinical outcome according to AOFAS score was
excellent in 12 patients, good in 6, fair in 4 and poor in 2.
Conclusion:
The study demonstrated that it is possible to achieve a satisfactory outcome, in pilon fractures,
with the Ilizarov technique allowing early definitive treatment. The fractures were treated
immediately after the injury, regardless of soft-tissue damage. This was done with a similar low
complication rate in both the extra- articular and the intra-articular fractures. Patient
compliance was good. The residual deformities were within the range in which the risk of
developing post- traumatic osteoarthritis can be expected to be low.