Ilizarov versus ORIF for Open AO Type-C Pilon Fractures

Area of Science:

• Orthopedic surgery
• Traumatology
• Reconstructive surgery

Background:

• Pilon fractures, specifically Type C, are complex distal tibia injuries requiring effective management.
• Open reduction internal fixation (ORIF) and Ilizarov external fixation are common treatment modalities.
• Evaluating the comparative effectiveness of these methods is crucial for optimizing patient outcomes.

Purpose of the Study:

• To compare the clinical effectiveness of ORIF versus Ilizarov fixation for Type C closed pilon fractures.
• To assess patient-reported outcomes, including the Disability Rating Index (DRI), quality of life (SF-12), and AOFAS score at 12 months.
• To evaluate radiographic outcomes such as fracture healing and malalignment.

Main Methods:

• Retrospective cross-sectional study including patients aged 18+ with AO type C pilon fractures.
• Comparison of outcomes between 15 patients treated with ORIF and 26 patients treated with Ilizarov fixation.
• Primary outcome: DRI scores at 12 months. Secondary outcomes: SF-12, AOFAS score, fracture healing, and malalignment.

Main Results:

• No statistically significant difference in DRI scores between ORIF and Ilizarov groups at 12 months.
• Comparable clinical outcomes and quality of life scores between the two treatment groups.
• Similar rates of unplanned surgical procedures (26.92% Ilizarov vs. 33.33% ORIF).

Conclusions:

• Neither ORIF nor Ilizarov fixation demonstrated superior disability status at 12 months for acute, displaced, intra-articular distal tibia fractures.
• Treatment decisions should consider individual patient factors for optimal management of pilon fractures.
• Both surgical techniques offer comparable outcomes in the management of Type C pilon fractures.