title: [Redintegration of articular surface and alignment with tibia type III Pilon fracture].
abstract: OBJECTIVE
  To explore an improved method of surgical operation for redintegration of the articular surface and alignment with type III Pilon fractures.
  
  
  METHODS
  Between August 2005 and August 2010, 31 patiens with closed type III Pilon fracture (Rüedi-Allgöwer type III) were treated. There were 25 males and 6 females, aged 36.8 years on average (range, 16-60 years). The injury was caused by falling from height in 18 patients, by traffic accident in 10 patients, and by other reasons in 3 patients. The average time between injury and operation was 10 days (range, 6-14 days). Temporary external fixation was used for adjustment and maintenance of limb length and power lines; application of fibular flip combined with anteromedial approach was used for the repair of articular surface; and bone grafting and fixation were performed.
  
  
  RESULTS
  No extensive necrosis or deep infection were observed. Superficial skin infection of incision and wound edge necrosis occurred in 2 cases respectively, and were cured after dressing change. All patients were followed up 26 months on average (range, 9-79 months). According to the Burwell et al. judging standards of radiology evaluating, the anatomical reduction was found in 25 cases (80.6%), satisfactory reduction in 4 cases (12.9%), and unsatisfactory reduction in 2 cases (6.5%). The X-ray films showed bony healing was achieved in all cases with an average fracture healing time of 16 weeks (range, 12-25 weeks). According to the Mazur et al. criterion for ankle joint function, excellent result was obtained in 11 cases, good in 13, fair in 5, and poor in 2; the excellent and good rate was 77.4%.
  
  
  CONCLUSIONS
  Good exposure and fixation of articular surface or accurate adjustments and maintenance of the limb alignment are key factors of successful operation to treat type III Pilon fractures.
authors.affiliation: Department of Orthopaedics, Third Affiliated Hospital of Jianghan University, Wuhan Hubei 430300, PR China. lihongjun7172@163.com
authors.forename: Hongjun
authors.initials: H
authors.lastname: Li
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Cao
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
authors.forename: Chunlei
authors.initials: C
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D016025:Bone Transplantation; D016267:External Fixators; D005260:Female; D005360:Fibula / Q000293:injuries / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult