Ilizarov fixation of tibial plafond fractures | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 47, Issue 4, December 2012, Pages 368-374 PDF (308.12 K) | ||
| Author | ||
| Mohamed A.S. Laklouk | ||
| Abstract | ||
| Objectives This study was conducted to evaluate whether supplementary fibular fixation can affect reduction and maintain it and also to assess its effect in the healing process of distal metaphyseal tibial and fibular fractures treated by Ilizarov external fixation. Patients and methods A total of 28 patients met our inclusion criteria. All patients had a displaced distal third fibular fracture, associated with a distal tibial metaphyseal fracture, that needed to be fixed by Ilizarov external fixation between 2004 and 2008. The 28 patients with fractures were divided into the following three groups on the basis of the treatment method for the fractured fibula: group A comprised eight patients with fibular fractures treated by open reduction and plate fixation; group B comprised nine patients with fibular fractures treated by open reduction and intramedullary (IM) fixation; and group C comprised 11 patients with fibular fractures treated conservatively by closed reduction. Results There was a 100% union rate. The average functional and radiological outcome for all groups was satisfactory in 75% of patients. The radiographs were reviewed for adequacy of fracture reduction and for the presence of post-traumatic arthrosis if any. At the end of follow-up, the clinical outcomes were evaluated using the rating scale of Teeny andWiss. The three groups were similar with respect to AO/OTA type, open fracture grade, and demographics. Patients in group A showed a decreasing trend of malunion and ankle arthrosis compared with those in group C (P>0.05). They also had a better clinical outcome than those in group C (P<0.05). In addition, patients in group A showed an increasing trend of satisfactory outcome compared with those in group B (P>0.05). Conclusion We concluded that supplementary rigid fixation of the fibular fracture associated with pilon fractures provides strong ankle stability and might decrease postoperative ankle arthrosis. IM fixation of the fibula has been proven to be a stable method of fixation that can also help achieve a reasonable reduction in associated distal tibial fractures. We recommend using IM fixation of the fibula in patients with fibular fractures associated with either pilon or distal tibial fractures. | ||
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