Comparison of External Circular Fixation and Plate and Screw Fixation Methods in Tibial Pilon Fractures

Abstract

Objective To compare the fixation methods for tibial pilon fractures among patients treated in a hospital.

Methods We analyzed the medical records of 28 patients who underwent a surgical procedure for tibial pilon fracture, among whom 15 subjects received a circular external fixator, and 13 underwent internal fixation using a plate and screws. We assessed age, sex, aggravating factors, trauma energy (high or low), presence of soft tissue injuries, associated fractures, and clinical outcomes.

Results Most patients were male, aging between 40 and 60 years. The most common trauma mechanism was car accident, and the associated injury was a fracture of the distal third of the fibula. The fracture patterns in patients treated with a circular external fixator were AO 43C3 and 43C2. As for the prevalent fracture patterns in the internal fixation group, we identified AO 43C1, 43C2, and 43C3.

Conclusion An individualized therapeutic choice is critical for a better functional outcome. Additionally, it is essential to highlight that the profile of fractures and patients in the circular external fixator and internal fixation groups tends to be quite heterogeneous, because the treatment of fractures with the worst classification and most frequently associated with soft tissue injuries often uses circular external fixation; meanwhile, those with less severe fractures and a lower incidence of soft tissue injuries are usually managed with open reduction and internal fixation. We noted that the clinical and radiographic outcomes tended to be similar between both groups despite the particularities of each method.

Keywords

external fixators - Ilizarov technique - tibial fractures

Financial Support

This authors declare that they did not receive financial support from agencies in the public, private, or non-profit sectors to conduct the present study.

Work carried out at the Orthopedics and Traumatology Service, Hospital e Maternidade Marieta Konder Bornhausen, Itajaí, SC, Brazil.

Publication History

Received: 06 November 2023

Accepted: 23 June 2024

Article published online:
07 December 2024

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