Clinical and Functional Outcomes of Open Reduction and Internal Fixation in Fresh Displaced Pilon Fractures

Introduction: There are several methods for treatment of pilon fracture. We propose to evaluate the clinical and functional outcome in terms of union of the fracture, mobilisation, weight bearing, infections and wound coverage after open reduction and internal fixation in closed fresh displaced pilon fracture with the help of distal tibial locking compression plate. Even though we have conducted this study to compare our results with the various national and International studies.

Method: We have conducted a prospective study for 40 cases of Fresh displaced tibial pilon fractures in patients aged between 18yrs - 65yrs attending the OPD and Emergency department of Orthopaedics, Gauhati Medical College & Hospital, Guwahati who met the inclusion criteria outlined below. Patients were treated by open reduction and internal fixation of the fractures with Distal Tibial lock plate with or without Fibula plating.

Results: Patient were followed up for two years evaluated by AOFAS score and compared with standard study. From our study we have obtained 21(52.5%) of patients have Excellent result, 10(25%) of patients have Good, 7(17.5%) patients have Fair and 2(5%) have poor result.

Conclusion: Restoration of length, articular reduction, articular congruity, axial and rotational alignment with better soft tissue handling are key to excellent functional results following fractures of tibial pilon. Final outcome depends upon chondral damage, residual articular displacement, soft tissue scarring and early mobilization.The functional result is directly proportionate to the anatomical reduction and fixation during operation and inversely proportionate to the fracture comminution.