Qi-jie Shen1, Ya-bin Liu, Shuo Jin. 1. Department of Orthopedics & Traumatology, Tianjin Hospital, Tianjin, China. dhshentj@sina.com
Abstract
OBJECTIVE: To explore the relevant influencing factors of surgical outcomes for closed tibial pilon fractures. METHODS: From April 2005 to May 2011, 52 consecutive closed tibial pilon fractures were treated by the same surgical team. There were 35 males and 17 females with a mean age of 40.0 years. According to the Ruedi-Allgower classification, the fracture types included type I (n = 13), type II (n = 22) and type III (n = 17). All patients were evaluated by the scores of American Orthopedic Foot and Ankle Society (AOFAS) and Burwell-Chamley. Postoperative complications were also recorded. The primary influencing factors of clinical outcomes were determined with regards to fracture types, reduction, complications and outcomes. RESULTS: The average follow-up period was 14.1 months (range: 6 - 28). The mean healing time was 5.5 months (range: 4.0 - 11). The reduction status: anatomical (n = 20), functional (n = 24) and poor (n = 8). Ankle function was excellent (n = 12), good (n = 26), fair (n = 9) and poor (n = 5). Incidence of complication was 30.8% (n = 16), including incision skin necrosis (n = 5), superficial soft tissue infection (n = 4), deep infection (n = 1) and posttraumatic arthrosis (n = 6). No significant differences (P > 0.05) existed in the occurrence of incision skin necrosis, superficial infection and deep infection between the outcomes of excellent/good and fair/poor groups while posttraumatic arthrosis rate had significant difference (P = 0.005) between two groups. The quality of reduction was an independent risk factor of final clinical outcomes. CONCLUSION: The quality of reduction, types of fracture and occurrence of posttraumatic arthrosis are risk factors of final outcomes for closed tibial pilon fractures.
OBJECTIVE: To explore the relevant influencing factors of surgical outcomes for closed tibial pilon fractures. METHODS: From April 2005 to May 2011, 52 consecutive closed tibial pilon fractures were treated by the same surgical team. There were 35 males and 17 females with a mean age of 40.0 years. According to the Ruedi-Allgower classification, the fracture types included type I (n = 13), type II (n = 22) and type III (n = 17). All patients were evaluated by the scores of American Orthopedic Foot and Ankle Society (AOFAS) and Burwell-Chamley. Postoperative complications were also recorded. The primary influencing factors of clinical outcomes were determined with regards to fracture types, reduction, complications and outcomes. RESULTS: The average follow-up period was 14.1 months (range: 6 - 28). The mean healing time was 5.5 months (range: 4.0 - 11). The reduction status: anatomical (n = 20), functional (n = 24) and poor (n = 8). Ankle function was excellent (n = 12), good (n = 26), fair (n = 9) and poor (n = 5). Incidence of complication was 30.8% (n = 16), including incision skin necrosis (n = 5), superficial soft tissue infection (n = 4), deep infection (n = 1) and posttraumatic arthrosis (n = 6). No significant differences (P > 0.05) existed in the occurrence of incision skin necrosis, superficial infection and deep infection between the outcomes of excellent/good and fair/poor groups while posttraumatic arthrosis rate had significant difference (P = 0.005) between two groups. The quality of reduction was an independent risk factor of final clinical outcomes. CONCLUSION: The quality of reduction, types of fracture and occurrence of posttraumatic arthrosis are risk factors of final outcomes for closed tibial pilon fractures.