[The small-fragment double plate osteosynthesis in c1 to c3 fractures of the tibial pilon.]
[The small-fragment double plate osteosynthesis in c1 to c3 fractures of the tibial pilon.]
Intra-articular fractures of the tibial pilon always have been a challenge for the surgeon and his operative technique. With conservative or operative management, we have to take care of destroyed articular surfaces and traumatised soft tissues. Therefore, tibial pilon fractures are known in the literature as complicated lesions with a high rate of complications. Between 1993 and 2001 twenty-one patients who were between 18 and 65 years old and suffered a monotrauma of the tibial pilon of the type C1 to C3 of the AO classification, were treated with a staged reconstruction. Stabilisation was done by small-fragment double plate osteosynthesis. In this retrospective study, we could review 17 patients clinically and radiologically and assess their outcome with the ankle hindfoot and the Bargon scores. In accordance with the ankle hindfoot score, there were 11 excellent and good results, 5 moderate and one poor. In accordance with the Bargon score, 41 % of the patients had a severe arthrosis, 24 % a moderate and 35 % a light to no arthrosis. Our results show that the small-fragment double plate osteosynthesis offers a high stability, allows careful soft tissue handling and can be done with a low ratio of complications. Long-term results are gratifying, although the radiological examinations often show a certain degree of arthrosis of the ankle joint.
Dietz SO, Müller-Bongartz F, Rommens PM.
Klinik und Poliklinik für Unfallchirurgie, Klinikum der Johannes-Gutenberg-Universität Mainz.