[The use of dynamic axial external fixator with modified technique in Pilon fractures of tibial].
OBJECTIVE
To retrospectively analyses the results of dynamic axial external fixator with modified technique in the treatment of severely Pilon fractures.


METHODS
From July 2000 to February 2003, 14 patients with severely Pilon fractures were treated with dynamic axial external fixator inserted with modified technique combined with limited open reduction and internal fixation with screws and Kirschner wires, with two distal external pins inserted into talus and calcaneus respectively so that the rotation axis of distal clamp was coincided with that of ankle joint. All patients were young or middle-aged people from 20 y to 52 y (average 38 y). All fractures were Rüedi-Allg were type II or type III. External fixators were removed after bone healing. Duration of follow-up was 5 - 36 m (average 18 m).


RESULTS
The time of bone healing was 12 - 24 weeks (average 14 weeks). At the latest follow-up, results include 5 excellent, 6 good and 3 fair according to ankle scoring system (ASS). There was only one case of superficial pin site infection settled with oral antibiotics and pin site care with mild disinfectants. There was no wound breakdown, superficial and deep infection, osteomyelitis, fracture fragments redisplacement and collapse.


CONCLUSIONS
Dynamic axial external fixator with modified technique combined with limited internal fixation is an effective method for the treatment of severely Pilon fractures.
Department of Orthopaedics, the 304th Hospital of People's Liberation Army, Beijing 100037, China.
Zhen-Zhou
ZZ
Li
Shu-Xun
SX
Hou
Ke-Jian
KJ
Wu
Wei-Jia
WJ
Zhang
Wei-Lin
WL
Shang
Wen-Wen
WW
Wu
D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*