title: Early internal fixation and soft tissue cover of severe open tibial pilon fractures.
abstract: We studied 32 consecutive patients with open distal tibial pilon fractures. All patients had radical debridement with immediate skeletal stabilisation and early soft-tissue cover with a vascularized muscle flap. The minimum follow-up was 1 (range 1-8) year. There were four superficial infections, two deep infections and two amputations. There were no long-term problems with union and no patient required an ankle fusion. Patients were assessed using the SF-36 questionnaire. There were significant differences from the US norm in physical function score ( p<0.01), role physical score ( p<0.05) and physical component score ( p<0.01). Physical component score of 38.5 was significantly better ( p<0.01) when compared with amputees from severe lower-extremity trauma. Our protocol for management resulted in a good functional outcome with low infection and amputation rates.
authors.affiliation: Department of Orthopaedics and Trauma, St. James University Hospital, Leeds, LS9 7TF, UK.
authors.forename: J
authors.initials: J
authors.lastname: Conroy
authors.forename: M
authors.initials: M
authors.lastname: Agarwal
authors.forename: P V
authors.initials: PV
authors.lastname: Giannoudis
authors.forename: S J E
authors.initials: SJ
authors.lastname: Matthews
mesh_terms: D000671:Amputation, Surgical; D003646:Debridement; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D013524:Surgical Flaps; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome