Results of Operative Treatment of Pilon Fractures
Between 1972 and 1985, a total of 380 tibial pilon fractures were managed by open reduction at the accident hospital in Feldkirch and the university clinic in Innsbruck, Austria. In Feldkirch almost all of these fractures were managed by open reduction whilst in Innsbruck about one half were managed closed . A total of 256 patients (68%) were followed for at least 2 and 15 years after surgery, with a mean follow-up time of 7.5 years [2, 5]. The right side was slightly more frequently involved than the left (53% vs 45%) and there was bilateral involvement in 2% of cases. The average age of the patients was 34 years (range 15–74 years) and there were more male patients (123) than females (71). Three hundred and forty-two fractures (90%) were closed and 38 (10%) open. The most common cause of the fractures was a skiing injury, which would be anticipated as both the hospitals are in the centre of popular skiing areas (Table 1). Using Heim’s classification there were 89 (22%) cleavage-type fractures, 177 (44%) fracture dislocations and 114 (34%) distal tibial fractures with extension into the ankle joint [3, 4].
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