title: [External fixation combined with limited internal fixation in the treatment of pilon tibia fractures].
abstract: OBJECTIVE
  Intraarticular fractures of the tibial plafond (pilon fractures) belong to the group of most severe fractures. They are usually caused by high-energy trauma and frequently associated with a marked soft-tissue damage. Surgical treatment has replaced the traditional nonoperative treatment. The aim of this study was to present the results of the treatment of distal tibial intraarticular fracture by the use of internal fixation, as well as the combination of minimal internal fixation and external fixation.
  
  
  METHODS
  The study included 47 patients with pilon tibia fractures who went through at the Clinic for Orthopedics and Traumatology, School of Medicine, Nis (1995-2004). Within the analayzed group there were 33 (70.2%) males and 14 (29.8%) females. The patients mean age was 45.8 years. In the first group, which consisted of 22 patients, open reduction and internal fixation of both the tibia and the fibula was performed in the two separate incisions. The second group consisted of 25 patients managed with external fixation by external fixator "Mitković" with limited internal fixation. Besides external fixation, a minimal internal fixation was performed by the use of Kirschner wires and screws. The patients were followed-up inside a 24-months-period. Results. The obtained was a substantially high number of complications after open reduction and internal fixation in the group of patients. There was no difference in a long-term clinical outcome. Postoperative osteitis, as the most severe complication in the management of closed pilon tibia fractures, was not registered in the second group.
  
  
  CONCLUSIONS
  Considering the results obtained in this study, it can be concluded that external fixation by the "Mitković" external fixator with the minimal internal fixation is a satisfactory method for the tratment of fractures of the tibial plafond causing less complications than internal fixation.
authors.affiliation: Klinicki centar, Ortopedsko-traumatoloska klinika, Bulevar Zorana Dindića br. 48, 18 000 Nis, Srbija. golubovicz@bankerinter.net
authors.forename: Zoran
authors.initials: Z
authors.lastname: Golubović
authors.forename: Lana
authors.initials: L
authors.lastname: Macukanović-Golubović
authors.forename: Predrag
authors.initials: P
authors.lastname: Stojiljković
authors.forename: Jovica
authors.initials: J
authors.lastname: Jovanović
authors.forename: Ivan
authors.initials: I
authors.lastname: Micić
authors.forename: Danilo
authors.initials: D
authors.lastname: Stojiljkovioć
authors.forename: Dragan
authors.initials: D
authors.lastname: Milić
authors.forename: Milorad
authors.initials: M
authors.lastname: Mitković
mesh_terms: D000328:Adult; D000368:Aged; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000379:methods; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*