Pilon Fracture Management: Distal Tibial Locking Plate Vs Ilizarov

Authors

  • Muhammad Awais Tahir Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.
  • Rana Dawood Ahmed Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.
  • Allah Rakha Hassan Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.
  • Shaharyar Ahmed Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.
  • Haidar Ali Khalid Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.
  • Ajmal Khandan Department of Orthopedic Surgery, Allied Hospital, Faisalabad, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i4.1096

Keywords:

Pilon Fracture, Locking Plate, Ilizarov, Lower Extremity, Functional Score

Abstract

Introduction: Several methods have been used to treat tibial pilon fractures, while the best course of action is still up for debate. In order to restore the distal fibula length and articular surface, these patients are typically treated in Europe with open reduction and internal fixation of the tibia, with bone grafting as needed. Study design: Randomized Controlled trial. Settings: Department of Orthopedic Surgery, Allied Hospital, Faisalabad. Study duration: November 2024 and February 2025. Materials and Procedures: 256 patients (128 in each group) of either gender, aged 18 to 50, who presented with Anderson grade 1 traumatic extra-articular/intra-articular distal tibial fractures were chosen. Patients with compartment syndrome, generalized bone or joint disease, pathological fractures, uncontrolled diabetes mellitus, peripheral vascular disease, other significant injuries or polytrauma, and prior surgery were excluded. The patients were split into two groups at random using the lottery method. Group A were undergone tibial locking plate and group B were undergone ilizarov technique. The lower extremity functional score (LEFS), as described by the patient, is the main result. The functional score for the lower extremities ranges from 0 to 80 points. Results: Patients in groups A and B had mean ages of 36.17 ± 8.33 and 37.02 ± 7.16 years, respectively. With a male to female ratio of 2.5:1, 182 (71.09%) patients were males and 74 (28.91%) were females. The mean LEFS score at 12 weeks was 61.80 ± 4.55 for group A and 64.66 ± 5.24 for group B (p-value = 0.0001). Conclusion: In comparison to ilizarov technique, this study found that tibial locking plate offers superior lower extremity function score.

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References

Marwan Y, Turner J, Senan R, Muir R, Barron E, Hadland Y, et al. Circular external fixation for revision of failed tibia internal fixation. Eur J Orthop Surg Traumatol. 2024;34(1):353-61. https://doi.org/10.1007/s00590-023-03660-5

Stenroos A, Puhakka J, Jalkanen J, Laaksonen T, Kivisaari R, Kosola J, et al. Risk of Premature physeal closure in fractures of distal tibia. J Pediatr Orthop B. 2021;30(1):25-31. https://doi.org/10.1097/bpb.0000000000000744

Zyskowski M, Wurm M, Greve F, Pesch S, von Matthey F, Pflüger P, et al. Is early full weight bearing safe following locking plate ORIF of distal fibula fractures? BMC Musculoskelet Disord. 2021;22(1):1-10. https://doi.org/10.1186/s12891-021-04009-x

Oguzkaya S, Misir A, Kizkapan TB, Eken G, Ozcamdalli M, Basilgan S. A Comparison of clinical, radiological, and quality-of-life outcomes of double-plate internal and ilizarov external fixations for schatzker type 5 and 6 tibia plateau fractures. Eur J Trauma Emerg Surg. 2022;48(3):1087-95. https://doi.org/10.1007/s00068-021-01713-0

Hassan SMT, Saud AM, Khan AGS, Ali R, Zeb SA, Raza T, et al. Clinical and functional outcomes in patients with distal tibial fracture treated by circular external fixation. Biol Clin Sci Res J. 2024;34(1):899-906. https://doi.org/10.54112/bcsrj.v2024i1.899

Hui T, Wang J, Yu Y, Dong H, Lin W. External fixator versus ilizarov external fixator for pediatric tibial shaft fractures: a retrospective comparative study. Injury. 2024;55(2):111-6. https://doi.org/10.1016/j.injury.2024.111376

Saeed M, Inam M, Haq S, Ahmad I. Distal tibial fracture managed by circular external fixation: clinical and functional outcomes. J Health Rehab Res. 2024;4(13):1-6.

Sharma JK, Chaudhary P, Rijal R, Pokharel B. Randomized controlled trial comparing outcome of hybrid Ilizarov versus distal tibial metaphyseal locking plate (P) for treatment of distal tibial fractures in adults. Int J Res Orthop 2018;4:357-66. https://doi.org/10.18203/issn.2455-4510.intjresorthop20181794

Giannoudis VP, Ewins E, Taylor DM, Foster P, Harwood P. Clinical and functional outcomes in patients with distal tibial fracture treated by circular external fixation: a retrospective cohort study. Strategies in Trauma and Limb Reconstruction. 2021 May;16(2):86. https://doi.org/10.5005/jp-journals-10080-1516

Tukade MB. A comparative prospective study on various methods of management of distal tibial fractures in a tertiary care hospital. Int J Acad Med Pharm. 2023;5(3):19-25.

Ramlee MH, Gan HS, Daud SA, Abdul Wahab A, Abdul Kadir MR. Stress distributions and micromovement of fragment bone of pilon fracture treated with external fixator: a finite element analysis. J Foot Ankle Surg. 2020;59(4):664–72. https://doi.org/10.1053/j.jfas.2019.09.006

Kumar J, Siddiqui AA, Katto MS, Jamil M, Wasim MA, Yaqoob U. Treatment of high-energy intra-articular fractures of tibia with Ilizarov external fixator in adults: a tertiary centre experience. Int J Clin Pract. 2021;75(9):e14488. https://doi.org/10.1111/ijcp.14488

Lim JA, Thahir A, Zhou AK, Girish M, Krkovic M. Definitive management of open pilon fractures with fine wire fixation. Injury. 2020;51(11):2717–722. https://doi.org/10.1016/j.injury.2020.08.029

Meng YC, Zhou XH. External fixation versus open reduction and internal fixation for tibial pilon fractures: a meta-analysis based on observational studies. Chinese J Traumatol. 2016;19(05):278–82. https://doi.org/10.1016/j.cjtee.2016.06.002

Stavlas P, Polyzois D. Septic arthritis of the major joints of the lower limb after periarticular external fixation application: are conventional safe corridors enough to prevent it? Injury. 2005;36(2):239–47. https://doi.org/10.1016/j.injury.2004.06.008

Hu C, Zhu W, Chahal K, Zhu N, Fang W, Jing J, et al. Open reduction and internal fixation of Gustilo type-I and type-II open pilon fractures using a lateral approach. J Orthop Surg. 2019;27(3):2309499019864722. https://doi.org/10.1177/2309499019864722

Mehta N, Graham S, Lal N, Wells L, Giotakis N, Nayagam S, et al. Fine wire versus locking plate fixation of type C pilon fractures. Europ J Orthop Surg Traumatol. 2022;32(5):875–82. https://doi.org/10.1007/s00590-021-03048-3

White TO, Guy P, Cooke CJ, Kennedy SA, Droll KP, Blachut PA, et al. The results of early primary open reduction and internal fixation for treatment of OTA 43. C-type tibial pilon fractures:a cohort study. J Orthop Trauma. 2010;24(12):757–63. https://doi.org/10.1097/bot.0b013e3181d04bc0

Olson JJ, Anand K, von Keudell A, Esposito JG, Rodriguez EK, Smith RM, et al. Judicious use of early fixation of closed, complete articular pilon fractures is not associated with an increased risk of deep infection or wound complications. J Orthop Trauma. 2021;35(6):300–7. https://doi.org/10.1097/bot.0000000000001991

Wu D, Peng C, Ren G, Yuan B, Liu H. Novel anterior curved incision combined with MIPO for Pilon fracture treatment. BMC Musculoskeletal Disord. 2020;21(1):1–9. https://doi.org/10.1186/s12891-020-03207-3

Silluzio N, De Santis V, Marzetti E, Piccioli A, Rosa MA, Maccauro G. Clinical and radiographic outcomes in patients operated for complex open tibial pilon fractures. Injury. 2019;50:S24–S28. https://doi.org/10.1016/j.injury.2019.01.041

Lu V, Zhang J, Zhou A, Thahir A, Lim JA, Krkovic M. Open versus closed pilon fractures:Comparison of management, outcomes, and complications. Injury. 2022;53(6):2259–67. https://doi.org/10.1016/j.injury.2022.03.018

Chen Y, Li Y, Ouyang X, Zhang H. Ankle joint salvage and reconstruction by limited ORIF combined with an Ilizarov external fixator for complex open tibial pilon fractures (AO 43-C3 3) with segmental bone defects. BMC Musculoskeletal Disord. 2022;23(1):1–10. https://doi.org/10.1186/s12891-022-05060-y

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Published

2025-04-15

How to Cite

Pilon Fracture Management: Distal Tibial Locking Plate Vs Ilizarov. (2025). Indus Journal of Bioscience Research, 3(4), 554-558. https://doi.org/10.70749/ijbr.v3i4.1096