Journal of Korean Foot and Ankle Society (대한족부족관절학회지)

Korean Foot & Ankle Society (대한족부족관절학회)
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Result of Staged Operation in Ruedi-Allgower Type II and III Open Tibia Pilon Fractures with Severe Comminution

분쇄가 심한 Ruedi-Allgower II, III형의 개방성 경골 천정 골절에서 단계적 수술의 결과

  • Choi, Kwi Youn (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Lee, Jun Young (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Jang, Hyunwoong (Department of Orthopaedic Surgery, College of Medicine, Chosun University) ;
  • Kim, Young Wook (Department of Orthopaedic Surgery, College of Medicine, Chosun University)
  • 최귀연 (조선대학교 의과대학 정형외과학교실) ;
  • 이준영 (조선대학교 의과대학 정형외과학교실) ;
  • 장현웅 (조선대학교 의과대학 정형외과학교실) ;
  • 김영욱 (조선대학교 의과대학 정형외과학교실)
  • Received : 2019.04.04
  • Accepted : 2019.08.26
  • Published : 2019.09.15
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Abstract

Purpose: This study analyzed the clinical and radiological results of Reudi-Allgower type II and III open tibia pilon fracture patients who underwent plate fixation after the recovery of a soft tissue injury after external fixation. Materials and Methods: From 2010 to 2015, this study analyzed 14 patients who were treated for open tibial pilon fractures and could be followed up at least one year. The mean age was 49 years and the average follow-up period was 19 months. An emergency operation was performed for external fixation and open wounds, and secondary surgery was performed for definitive fixation using a plate. The radiological and clinical evaluations were analyzed retrospectively. Complications, such as post-traumatic osteoarthritis and wound infections were also analyzed. Results: The mean duration between two-staged surgery was 21 days and the mean bone union time was 9.2 months. Three cases of delayed union and one case of nonunion were reported. The malunion did not occur in all cases. The average American Orthopaedic Foot and Ankle Society (AOFAS) score was 68 points. A limitation of the ankle motion occurred in all cases. In four cases, wound infections due to initial open wounds occurred; one patient underwent a below the knee amputation due to chronic osteomyelitis. Post-traumatic arthritis occurred in 10 cases. Conclusion: Severe comminuted tibial plateau open fractures of Reudi-Allgower type II and III, which are high-energy injuries that result in extensive soft tissue damage, have a higher incidence of complications, such as ulcer problems and osteomyelitis, than closed tibia plateau fractures. Post-traumatic arthritis is the most common complication of tibia plateau open fractures, and staged surgery is recommended because of the relatively satisfactory clinical results.

Keywords

References

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