Impact of the fibula fractures and syndesmotic injuries on the prognosis of the tibial pilon fractures

Authors: METİN DOĞAN, MAHMUT UĞURLU, DURMUŞ ALİ ÖÇGÜDER, NİHAT TOSUN

Abstract: To evaluate tibial pilon fractures, as well as the type of fibula fracture, and the presence of injury to the inferior tibiofibular joint. Materials and methods: The study included 42 patients (34 male, 8 female) who underwent surgery for pilon fractures and were followed up. The mean follow-up period of the patients was 72 months (range: 36-102 months). The patients were classified into 2 groups as Ruedi-Allgower (RA) Type II, including 20 patients and RA Type III, including 22 patients. The fibula fractures of the patients were classified according to the Weber classification. The reduction quality was determined by evaluating the early postoperative graphs of the patients based on the scale defined by Conroy et al. The standard anterior-posterior and side graphs were investigated for arthrosis. The clinical evaluation of the ankles of the patients was based on the rating scale of Teeny and Wiss. Results: In the RA Type II group, Weber B fibular fractures were significantly more common and, in the RA Type III group, Weber C fibular fractures were significantly more common (P < 0.001). Comparisons of the fibular fracture types revealed that in Weber Type C fractures, the incidence of posttraumatic arthrosis was higher (P < 0.05). The clinical evaluations recorded on the final controls of the patients showed that sufficient outcome was achieved in 55% of the patients with RA Type II fractures and in 45.5% of the patients with the RA Type III fractures. Conclusion: The type of fibular fracture and the presence of syndesmotic injury affect the functional outcome of pilon fractures.

Keywords: Tibial pilon fracture, fibula fracture, syndesmotic injuries

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