[Redintegration of articular surface and alignment with tibia type III Pilon fracture]

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Skeletal Reconstruction

Background:

• Type III Pilon fractures present complex challenges in articular surface reconstruction and limb alignment.
• Current surgical methods require refinement to optimize outcomes for these severe injuries.

Purpose of the Study:

• To evaluate an improved surgical approach for redintegrating the articular surface and restoring alignment in type III Pilon fractures.
• To assess the efficacy and safety of a combined surgical technique involving temporary external fixation, fibular flip, and anteromedial approach.

Main Methods:

• A cohort of 31 patients with closed type III Pilon fractures underwent surgical treatment.
• The procedure involved temporary external fixation for limb alignment, a fibular flip with an anteromedial approach for articular surface repair, and bone grafting with fixation.
• Patients were followed up for an average of 26 months.

Main Results:

• Anatomical reduction was achieved in 80.6% of cases, with satisfactory reduction in 12.9%.
• All fractures achieved bony healing within an average of 16 weeks.
• The excellent and good functional outcome rate was 77.4% according to the Mazur et al. criterion.

Conclusions:

• Effective surgical management of type III Pilon fractures relies on achieving good exposure and stable fixation of the articular surface.
• Accurate adjustment and maintenance of limb alignment are critical for successful surgical outcomes.
• The described surgical technique demonstrates promising results for treating complex Pilon fractures.