The Outcomes of Pilon Fracture Treatment: Primary Open Reduction and Internal Fixation Versus Two stage Approach

Document Type : RESEARCH PAPER


1 Taleghani Hospital, Research Development Unit, Department of Orthopedic Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2 Taleghani hospital, research development unit, Department of orthopaedic surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3 Taleghani hospital, research development unit, Department of orthopedics surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran


Background: Pilon fracture is one of the challenging injuries in orthopedic surgery. Associated soft tissue injury is an
important factor in choosing treatment options. Two major methods of treatment are considered as one-stage open
reduction internal fixation (ORIF) and two-stage treatment (primary external fixation and secondary ORIF). The latter is
most accepted in literature. In the current study, we compared the results of these two methods.
Methods: In a retrospective study, 41 patients were assigned to two groups containing one-stage primary ORIF (21
patients) group, and two-stage group included external fixation and secondary ORIF (20 patients). The rate of infection
(superficial or deep infection, osteomyelitis), malunion, nonunion, duration of hospital stay, neurovascular injury, pain
intensity, and patients’ satisfaction with AOFAS score, were compared between the two groups.
Results: There was no significant difference between the two groups in measured variables except hospital stay
which was significantly longer for the two-stage group.
Conclusion: Based on our findings, we recommend using one stage ORIF for a patient with Pilon fractures type C
and Tscherne 1, 2 if the patient is planned to be operated on during the first 24 hours after the injury.
Level of evidence: II


Main Subjects

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Volume 6, Issue 5
September 2018
Pages 412-419
  • Receive Date: 17 July 2017
  • Revise Date: 22 December 2017
  • Accept Date: 30 December 2017
  • First Publish Date: 01 September 2018