title: Capsuloligamentotaxis and definitive fixation by an ankle-spanning Ilizarov fixator in high-energy pilon fractures.
abstract: Open reduction and internal fixation of high-energy pilon fractures are often associated with serious complications. Various methods have been used to treat these injuries, with variable results. A total of 17 consecutive patients with pilon fractures of AO/OTA type 43-B3 (n = 1), type C2 (n = 12) and type C3 (n = 4) were treated by indirect reduction by capsuloligamentotaxis and stabilisation using an ankle-spanning Ilizarov fixator. The calcaneal ring was removed at a mean of 3.7 weeks (3 to 6). A total of 16 patients were available for follow-up at a mean of 29 months (23 to 43). The mean time to healing was 15.8 weeks (13 to 23). Nine patients had pin-track infections but none had deep infection or osteomyelitis. Four patients (25%) had malunion. Fair, good or excellent ankle scores were found in 14 patients. External fixation with a ring fixator achieves stable reduction of the fractured fragments without additional trauma to soft tissues. With minimum complications and good healing results, the Ilizarov apparatus is particularly useful for high-energy pilon fractures.
authors.affiliation: Lady Hardinge Medical College, New Delhi, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Kapoor
authors.forename: H
authors.initials: H
authors.lastname: Kataria
authors.forename: S R
authors.initials: SR
authors.lastname: Patra
authors.forename: T
authors.initials: T
authors.lastname: Boruah
mesh_terms: D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D000843:Ankle Joint / Q000503:physiopathology; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D017102:Fracture Healing; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008023:Ligaments, Articular / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular; D013530:Surgical Wound Infection / Q000209:etiology; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome