Neglected Tibial Pilon Fractures: Can Arthrodesis Be Avoided?

Area of Science:

• Orthopedic Surgery
• Traumatology

Background:

• Neglected pilon fractures present significant challenges in orthopedic trauma.
• Late presentation of these fractures often complicates treatment and prognosis.

Purpose of the Study:

• To evaluate the efficacy of the Ilizarov fixator in managing neglected pilon fractures.
• To determine if Ilizarov fixation can prevent the need for ankle arthrodesis in these cases.

Main Methods:

• Retrospective case series of 18 patients with pilon fractures presenting late (>1 month).
• Treatment involved closed reduction, deformity correction, and alignment using the Ilizarov fixator.
• Radiographic and functional assessments (AOFAS Ankle-Hindfoot Scale) were performed.

Main Results:

• Satisfactory reduction quality was achieved in 15 out of 18 patients.
• All fractures healed without deep infection; arthrodesis was only required in 3 cases.
• The mean AOFAS score was 82.67, indicating good functional outcomes.

Conclusions:

• The Ilizarov fixator is a successful treatment for neglected pilon fractures.
• This technique effectively manages complex fractures while preserving ankle function and avoiding arthrodesis in the majority of cases.