title: Comparison of two-staged ORIF and limited internal fixation with external fixator for closed tibial plafond fractures.
abstract: OBJECTIVE
  To compare the results of two-staged open reduction and internal fixation (ORIF) and limited internal fixation with external fixator (LIFEF) for closed tibial plafond fractures.
  
  
  METHODS
  From January 2005 to June 2007, 56 patients with closed type B3 or C Pilon fractures were randomly allocated into groups I and II. Two-staged ORIF was performed in group I and LIFEF in group II. The outcome measures included bone union, nonunion, malunion, pin-tract infection, wound infection, osteomyelitis, ankle joint function, etc. These postoperative data were analyzed with Statistical Package for Social Sciences (SPSS) 13.0.
  
  
  RESULTS
  Incidence of superficial soft tissue infection (involved in wound infection or pin-tract infection) in group I was lower than that in group II (P < 0.05), with significant difference. Group I has significantly less radiation exposure (P < 0.001). Group II had higher rates of malunion, delayed union, and arthritis symptoms, with no statistical significance. Both groups resulted similar ankle joint function. Logistic regression analysis indicated that smoking and fracture pattern were the two factors significantly influencing the final outcomes.
  
  
  CONCLUSIONS
  In the treatment of closed tibial plafond fractures, both two-staged ORIF and LIFEF offer similar results. Patients undergo LIFEF carry significantly greater radiation exposure and higher superficial soft tissue infection rate (usually occurs on pin tract and does not affect the final outcomes).
authors.affiliation: Traumatology Department, Ji-Shui-Tan Hospital/Peking University, No. 31 East Street, Xin Jie Kou, Peking, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.forename: Lei
authors.initials: L
authors.lastname: Huang
authors.forename: Manyi
authors.initials: M
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D016267:External Fixators; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods; D005596:Fractures, Closed / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult