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Treatment of pilon fractures with low profile plates
Ali Andalib1, Mohammad Reza Etemadifar1, Aryan Rafiee Zadeh2
1Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Sciences Isfahan, Iran.
Insights
Low profile plates for pilon fractures show comparable complication rates to other methods. This study evaluated infection, union, and functional outcomes in 27 patients, finding superficial infections in 26% and malunion in 18.5%.
Area of Science:
- Orthopedic Surgery
- Trauma Surgery
- Lower Extremity Fractures
Background:
- Pilon fractures present significant surgical challenges due to high rates of post-operative complications.
- Evaluating novel or alternative fixation methods is crucial for improving patient outcomes.
Purpose of the Study:
- To assess the complication profile of using low profile plates for treating pilon fractures.
- To analyze surgical site infections, union rates, and functional recovery following fixation with low profile plates.
Main Methods:
- A clinical trial involving 27 patients with pilon fractures treated with low profile plates between 2017-2021.
- Data collected included demographics, fracture type, and post-operative complications (infections, osteomyelitis, vascular injuries, non-union, malunion) assessed at 1, 3, and 6 months.
- Patient function was evaluated using the American Orthopedic Foot and Ankle Score (AOFAS).
Main Results:
- Superficial wound infection occurred in 26% of patients, deep surgical site infection in 7.4%, and osteomyelitis in 3.7%.
- No vascular injuries were reported. Non-union was observed in 7.4% and malunion in 18.5% (anterior-posterior axis).
- The mean AOFAS score was 88.36 ± 14.20.
Conclusions:
- Treatment of pilon fractures with low profile plates demonstrates a complication profile comparable to existing treatment modalities.
- Low profile plates appear to be a viable option for pilon fracture management, with careful monitoring for potential complications.
Background:
Treatments of pilon fracture is an important operative challenge due to high prevalence of post-operative complications. In this paper, we aimed to evaluate the complications of the use of low profile plates for pilon fractures.
Methods:
This clinical trial that was performed in 2017-2021 in Isfahan on 27 patients with pilon fractures. Demographic data of patients such as age, gender, type of pilon fracture and baseline pathology of pilon fractures were collected. Patients were treated using low profile plates under surgical procedures. Within 1 month, 3 months and 6 months after surgeries, patients were visited and assessed regarding superficial wound infections, deep wound infections, and evidence of osteomyelitis, vascular injuries, non-union and mal-union using both physical examinations and imaging studies via X-ray. We also measured the functions of cases using The American Orthopedic Foot and Ankle Score (AOFAS) questionnaire.
Results:
Most cases had 3 days (33.3%) and 5 days (33.3%) of hospitalization. Superficial wound infection was observed in 7 cases (26%). Deep surgical site infections were observed in 2 cases (7.4%) and we had only 1 case of osteomyelitis (3.7%). No vascular injuries were observed in this study. Evaluation of union among patients showed that 2 cases (7.4%) had non-union and 5 cases (18.5%) had malunion in the anterior-posterior axis, but none of the patients had malunion in the coronal axis. Based on AOFAS questionnaire, the mean score in patients was 88.36±14.20.
Conclusion:
Treatments of pilon fractures by low profile plates have similar complications compared to other treatment options.
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