Omnidirectional Internal Fixation by Double Approaches for Treating Rüedi-Allgöwer Type III Pilon Fractures

Area of Science:

• Orthopedic Surgery
• Traumatology
• Skeletal Repair

Background:

• Pilon fractures, specifically Rüedi-Allgöwer type III, present complex challenges in orthopedic trauma.
• Effective treatment strategies are crucial for optimal joint function and patient outcomes.
• Minimally invasive techniques are increasingly explored for complex fracture management.

Purpose of the Study:

• To evaluate the effectiveness and complication profile of omnidirectional internal fixation using a double approach for Rüedi-Allgöwer type III pilon fractures.
• To assess the quality of fracture reduction and fixation achieved with this surgical technique.
• To analyze patient-reported and physician-reported outcomes and functional recovery.

Main Methods:

• Retrospective analysis of 19 cases with Rüedi-Allgöwer type III unilateral closed pilon fractures.
• Treatment involved anteromedial and posterolateral approaches for reduction and omnidirectional internal fixation.
• Outcomes were assessed using Burwell-Charnley (imaging), Johner-Wruhs (functional), and Likert (efficacy) scoring systems.
• Follow-up averaged 16.2 months, with analysis of complications and bony union.

Main Results:

• All 19 patients achieved bony union, with 15 cases showing primary wound healing.
• 14 patients had anatomic articular surface reduction, and 5 had acceptable reduction (Burwell-Charnley).
• 78.9% of patients achieved excellent or good results (Johner-Wruhs), with low complication rates (no deep infection, hardware failure, etc.).

Conclusions:

• Omnidirectional internal fixation via double approaches is an effective treatment for Rüedi-Allgöwer type III pilon fractures.
• The technique provides satisfactory reduction, rigid fixation, and good joint function recovery.
• This method demonstrates a favorable safety profile with a low incidence of complications.