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Management Of Tibial Pilon Fractures With Spanning External Fixator Supported By K-Wires Fixation | ||
| Mustansiriya Medical Journal | ||
| Article 1, Volume 16, Issue 1, 2017, Pages 63-73 | ||
| Author | ||
| Zaid W. Al-Shahwanii | ||
| Abstract | ||
| Background: Pilon fractures of distal tibia result from axial load with high energy force That produce a spectrum of articular and metaphseal fractuers which are difficult to manage , especially when associated with soft tissue injuries with a high rate of complications when treated with primary open reduction & internal fixation, this drive the surgeon’s to use spanning external fixator & limited internal fixation like k-wirs as an alternative techique for definitive management. Patients & Method:Twenty cases of fractures of tibial pilon were collected; studied & treated in Al-Yarmook teaching hospital and Red Crescent surgical hospital during the period from October 2013 - october 2015.. The average age of the patients were thirty five years (range from twenty to fifty years),16 cases were male, 4 cases were female.. 14 cases of them had associated fibular fracture . all are managed by Spanning External fixation with k-wires supplment as an internal fixation to hold the scattered pieces of articular surface .. Results: among those 20 cases there are 8 cases had a good results regarding ankle movement a good union with preservation of ankle mortise .While 9 cases had fair results due to either mal-union or limitation of ankle movements and only 3 cases ended with poor results. There were only two cases complicated with infection (tibial osteomyelitis) (caseNo. 10 & No. 13) & were treated by proper antibiotics according to culture & sensitivity, also we had nine patients complain from pin tract infection which were treated by antibiotics and daily dressing. Discussion: The use of external fixation supported by k-wires to treat the metaphyseal portion of pilon (tibial plafond ) fractures with articular surface involvement has been reported to be associated with a lower rate of wound complications than open reduction & internal fixation.. and a good result of union . | ||
| Keywords | ||
| Pilon fracture; External fixation; wires | ||
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