Our results of surgical treatment in tibia pilon fractures

Pilon fractures are complex fractures involving the distal articular surface and metaphysis of the tibia. Pilon fractures occur with axial compression and torsional mechanisms resulting from high or low-energy trauma. Because of the poor results of non-surgical treatment, the use of operative methods for this fracture type has increased. If the appropriate timing and surgical approach are not carefully designed, it can predispose the patient to complications such as infection and nonunion. Proper management of both the bone and soft tissue element of the injury is essential for successful outcomes. Restoration of function while avoiding complications is the primary treatment goal. Our study included 31 patients who were operated for pilon fracture in our clinic between 2008 and 2020. Of the patients participating in the study, 12 (38.7%) were female and 19 (61.3%) were male. The mean age was 51.7±12.8 years (min=24-max=77). Of the fractures, 27 (87.1%) were closed and 4 (12.9%) were open. Fractures were classified according to AO/OTA and Ruedi-Allgower classifications using Preop imaging. Open fractures were grouped according to the Gustilo Anderson classification and the soft tissue condition of closed fractures was grouped according to the Tscherne and Ostern classification. The clinical, radiological and functional results of the patients were evaluated according to AOFAS, Weber and Teeny and Wiss scoring systems at the last follow-up. No significant difference was found between age groups, gender and etiologies in terms of fracture type. There was a significant difference between etiologies in terms of fracture type (p=0.042). The mean time to union of open fractures was found to be significantly higher than the mean time to union of closed fractures (p<0.001). When soft tissue complications were compared with Tscherne and Goetzen classification, treatment method (direct or progressive fixation), and tibia fixation methods, no significant difference was found between them. When the results of AOFAS, Weber and Teeny and Wiss protocols were compared with the fracture types, gender, age, fibula fixation methods and treatment method, etiology, tibia fixation type, Ruedi Allgower and AO/OTA classifications, no significant difference was observed between them. Keywords: Tibia Pilon Fracture, Tibia Distal End Fracture, Tibia Plafond