Balance Assessment Under Different Conditions in Patients with Surgically Treated Pilon Fracture Compared to Healthy...

Tibial pilon fractures are usually high-energy fractures that are linked to higher rates of complications and poor clinical outcomes, particularly concerning pain and walking impairments. However, few studies have evaluated postural stability among patients surgically treated for pilon fractures.

This pilot study aimed to evaluate static and dynamic balance in patients who have undergone unilateral pilon fracture fixation, compared to matched healthy controls.

Ten adult patients, post-fixation for unilateral pilon fracture (with clinical and radiological evidence of fracture healing and ability to bear full weight on the affected lower limb), completed a series of balance tests on K-Force plates. Ten matched healthy controls performed the same tests. Outcomes included CoP path length, CoP mean velocity, time to stabilisation (TTS), and peak force normalized to body weight.

Patients showed significantly increased mediolateral sway during bipodal stance (mean CoP velocity of 33.7 vs. 22.4 mm/s, p < 0.01), especially under eyes-closed conditions. In single-leg stance, CoP velocity on the affected limb was more than double that of controls (118 vs. 54 mm/s, p = 0.036). Dynamic tests revealed longer TTS after landing (1563 vs. 501 ms, p = 0.048) and lower force output during squats. The unaffected limb performed nearly normally in static tasks but was slower during dynamic stabilization.

Even after fracture healing, patients with tibial pilon fractures show persistent sensorimotor deficits and impaired balance.