Emergent and delayed hybrid external fixation management of tibial pilon fractures: A multicentric retrospective analysis of 80 patients

• Main Authors: Giuseppe Rollo, Marco Filipponi, Paolo Pichierri, Valentina Russi, Lorenzo Nalbone, Michele D'Arienzo, Sara Cavalera, Gianfranco Corina, Michele Bisaccia, Luigi Meccariello
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Journal of Acute Disease
• Subjects: Tibial Pilon; External fixation; Hybrid external fixation; Outcomes; Open fracture; Soft tissue Injury
• Online Access: http://www.jadweb.org/article.asp?issn=2221-6189;year=2017;volume=6;issue=4;spage=169;epage=174;aulast=Rollo
• ISSN: 2221-6189; 2589-5516

Objective: To report our experience with the hybrid external fixator in emergency.Methods: We assessed 80 cases of pilon fracture treated with the external fixator during the period of January 2009 and December 2016:55 men (69%) and 30 women (33%) with a mean age of 40 years (range between 16 and 70). About 45 occurred as isolated trauma, 35 instead were politrauma. Each patient underwent standard radiographic examination and a CT examination. There were 28 open fractures (35%), (Gustilo type 1, 2 and 3) while closed fractures showed soft tissue involvement of various grade (2-3 Tscherne classification). In all cases, the external fixation, sometimes associated with other reduction and synthesis techniques, was used. The timing of surgery was dictated by the condition of the soft tissues. For clinical evaluation, the Mazur score with mean follow-ups at 12 months was utilized.Results: The final range of ankle motion was 15 dorsal and 10 plantar flexion. In about 80 cases there was an average Mazur score of83. The mean score was 90; in open fractures 85 to 72. Radiographic healing of fractures in 60 patients occurred in 120 days (mean 105 days), at the time when the external fixator was removed.Conclusion: Pilon fractures are complex and often present complications; the definitive treatment, in emergency or delayed, with hybrid external fixator permits a stable synthesis with minimal soft tissue damage. Weight bearing maybe allowed early and functional recovery is generally good.