Surgical approach in difficult tibial pilon fractures

Area of Science:

• Orthopedic Surgery
• Traumatology

Background:

• Tibial pilon fractures are complex injuries with a high risk of complications.
• Effective management requires careful consideration of fracture patterns and soft tissue integrity.

Purpose of the Study:

• To determine the optimal timing and surgical approach for tibial pilon complex fractures.
• To analyze factors influencing outcomes and complications in these injuries.

Main Methods:

• Retrospective analysis of 7 patients with complex tibial pilon fractures.
• Fracture classification using AO system (43C2, 43C3, 43B3) and Gustilo open fracture grading.
• Surgical treatment categorized as one-step or two-step approaches based on soft tissue status.

Main Results:

• Fracture healing achieved in an average of 13.6 weeks, with one case of delayed consolidation.
• One open fracture developed post-traumatic arthrosis; no infections or implant failures occurred.
• Good to excellent functional outcomes (Ovadia score) were observed in 6 out of 7 patients.

Conclusions:

• Fracture type and soft tissue status are critical determinants of surgical outcomes.
• These factors guide the choice between one-step or two-step procedures and implant selection for tibial pilon fractures.