The results of two-staged operative management of pilon fractures–a review of 25 cases

To evaluate the two-staged operative fixation of Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) type C pilon fractures.Retrospective review of prospectively collected data.Twenty-five consecutive patients with AO/OTA type C pilon fractures.All the patients underwent immediate application of external fixator spanning the ankle joint and internal fixation of fibular fracture. After a mean duration of 12 days, the external fixator was removed and internal fixation of pilon fracture was performed.At average follow-up of 18 months, all patients were evaluated by using subjective, objective, and radiographic measurements as described by Burwell and Charnley. Range of motion and postoperative complications were also recorded.Twenty-three of the 25 fractures healed within an average of 4 months. Average range of motion was 7° of dorsiflexion, 31° of plantar flexion, 11° of eversion, and 13° of inversion. Subjective and objective measurements showed 80% good results, 12% fair results, and 8% poor results. Radiographs showed anatomic reduction in 84% cases and fair reduction in another 16% cases. There were no infections or soft tissue complications. The arthrodesis rate was 4%.A two-staged approach offers good outcome for the treatment of AO/OTA type C pilon fractures.