[Delayed combined approach with three plates internal fixation for Pilon fracture with fibula fracture]

To explore clinical effect of delayed internal fixation through anteromedial and posterolateral approach of ankle joint in treating Pilon fracture combined with fibula fracture.

From December 2016 to December 2018, 18 patients with Pilon and fibula fracture treated by internal fixation through anteromedial and posterolateral approach of ankle joint with three plates, including 12 males and 6 females, aged from 38 to 51 years old with an average of (44.00±3.45) years old. According to classification of Rüedi and Allgöwer, 9 patients were typeⅡand 9 patients were type Ⅲ. All patients were closed fractures. Burnell Charnley standard was used to evaluate reduction of articular surface fracture at 7 days after operation, and Mazur ankle evaluation grading system was used to compare the improvement of ankle function between 9 and 12 months after operation.

All patients were followed up for 12 to 18 months with an average of (14.00± 1.57) months. According to standard of Burwell Charnley at 7 days after operation, 13 patients got excellent results and 5 patients good. All fracture healed well from 9.5 to 15 months with an average of (12.00±1.43) months. No infection, skin necrosis, loosen and broken of internal fixation, loosing of fracture reduction occurred. Mazur ankle joint score at 12 months (92.11± 5.28) scores was higher than 9 months (89.33±5.20) scores (t=7.976, P<0.001) .

Delayed internal fixation through anteromedial and posterolateral approach of ankle joint for Pilon fracture combined with fibula fracture has advantages of simple operation, satisfied reduction, stable fixation, less postoperative complications and satisfied ankle joint function.