[Analyses of relevant influencing factors in the treatment of tibial pilon fractures].

OBJECTIVE

To explore the relevant influencing factors of surgical outcomes for closed tibial pilon fractures.

METHODS

From April 2005 to May 2011, 52 consecutive closed tibial pilon fractures were treated by the same surgical team. There were 35 males and 17 females with a mean age of 40.0 years. According to the Ruedi-Allgower classification, the fracture types included type I (n = 13), type II (n = 22) and type III (n = 17). All patients were evaluated by the scores of American Orthopedic Foot and Ankle Society (AOFAS) and Burwell-Chamley. Postoperative complications were also recorded. The primary influencing factors of clinical outcomes were determined with regards to fracture types, reduction, complications and outcomes.

RESULTS

The average follow-up period was 14.1 months (range: 6 - 28). The mean healing time was 5.5 months (range: 4.0 - 11). The reduction status: anatomical (n = 20), functional (n = 24) and poor (n = 8). Ankle function was excellent (n = 12), good (n = 26), fair (n = 9) and poor (n = 5). Incidence of complication was 30.8% (n = 16), including incision skin necrosis (n = 5), superficial soft tissue infection (n = 4), deep infection (n = 1) and posttraumatic arthrosis (n = 6). No significant differences (P > 0.05) existed in the occurrence of incision skin necrosis, superficial infection and deep infection between the outcomes of excellent/good and fair/poor groups while posttraumatic arthrosis rate had significant difference (P = 0.005) between two groups. The quality of reduction was an independent risk factor of final clinical outcomes.

CONCLUSION

The quality of reduction, types of fracture and occurrence of posttraumatic arthrosis are risk factors of final outcomes for closed tibial pilon fractures.