Volume 27, Issue 133, March 2023

Does a two-stage approach to treat tibia pilon fractures have a favorable consequence?

Sager Holyl Alruwaili¹, Fares Almarek², Mohammed Saeed Alharbi³, Mohammed Alharbi⁴, Ahmed Onayzan Alshammari^5♦, Saadeldin Ahmed Idris^5,6, Moaath Abdulaziz Alamir⁴

¹Department of Surgery, Orthopedic Division, College of Medicine, Jouf University, Sakaka, KSA
²Department of Orthopedic Surgery, Security Forces Hospital, Medical Cities, General Directorate of Medical Services, Ministry of Interior, Riyadh, KSA
³Department of Orthopedic Surgery, College of Medicine, Qassim University, KSA
⁴Department of Surgery, College of Medicine, Al Imam Mohammad Ibn Saud Islamic University, Riyadh, KSA
⁵Department of Surgery, College of Medicine, University of Hail, KSA
⁶Department of Surgery, Faculty of Medicine, Alzaiem Alazhari University, Khartoum, Sudan

^♦Corresponding author
Department of Surgery, College of Medicine, University of Hail, KSA

ABSTRACT

Background: Tibial pilon fractures are generally challenging to manage. The pattern of trauma and skin status all contribute to greater management outcomes. Despite the existence of numerous treatment techniques, no one has yet evolved the perfect method. Due to extended immobility, casts are frequently increasing the probability of non-union, malunion and joint stiffness. Aim: The study intended to assess the function and quality outcomes as well as the prevalence of sequelae in those who underwent the two-staged procedure in adults. Methodology: The research employed 21 patients with pilon fractures consecutively. The whole patients who were included in the study were older than 18 years and were given two staged processes of treatments for their fracture through the period between April 2019 and March 2022 at King Saud Medical City. The AO-OTA Classification is used to categorize fractured sides. The patients were followed up at predetermined intervals of 1,2,3,4,12,18,24 and 36 months and functional outcomes were reviewed utilizing AOFAS. Results: With a mean follow-up of 24.7 months (range, 12-36), a total of 21 pilon fractures (2 type 43-A, 10 type 43-B and 9 type 43-C) were studied. The average AOFAS score was 86.91. Thirteen individuals (61.9%) showed early, late, temporary or permanent concerns. Conclusion: All varieties of Pilon fractures are best treated with a two-stage orthopedic surgery owing to the high perceived functional result and briefer length of hospitalization.

Keywords: Pilon, distal tibia, fracture, staged surgery, soft tissue, ankle, complication

Medical Science, 2023, 27, e141ms2882

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DOI: https://doi.org/10.54905/disssi/v27i133/e141ms2882

Published: 11 March 2023