title: [Ilizarov external fixator in the management of tibial pilon fractures: ankle hinged vs ankle fixed frame].
abstract: OBJECTIVE
  In this study, we aimed to answer the following questions: (i) Do patients with tibial pilon fractures treated with an ankle hinge Ilizarov external fixator have a better ankle function versus ankle fixed? (ii) Is the incidence of posttraumatic arthrosis lower in patients treated with an ankle hinge Ilizarov external fixator?
  
  
  METHODS
  Between April 2002 and January 2008, data of 34 patients (26 males, 8 females; mean age 36.9 years; range 20 to 78 years) who were treated with Ilizarov external fixator due to tibial pilon fracture were retrospectively evaluated. The patients were divided into two groups including those with an ankle hinged Ilizarov external fixator (group A, n=16) and an ankle fixed Ilizarov external fixator (group B, n=18). Preoperative and postoperative complications in the patients and quality of reduction were evaluated. In the last follow-up visit, ankle plantar and dorsiflexion range of motion and length of tibia were goniometrically measured. The functional assessment of the patients was performed using Teeny and Wiss scale. Posttraumatic arthrosis in the standard ankle X-rays was investigated.
  
  
  RESULTS
  The mean degree of plantar flexion was significantly higher in group A (25° in group A, 12.4° in group B). In the last visit, satisfactory results were obtained in 62.5% patients of group A and in 38.8% patients of group B according to Teeny and Wiss scale. Repeated X-rays revealed posttraumatic arthrosis in 31.3% patients of group A (n=5) and in 55.5% patients of group B (n=10).
  
  
  CONCLUSIONS
  The selection of an ankle hinged Ilizarov external fixator and early joint movement is an effective treatment method for the management of tibial pilon fractures usually accompanied by soft tissue injuries.
authors.affiliation: Department of Orthopedics and Traumatology, Ankara Atatürk Training and Research Hospital, 06800 Ankara, Turkey. ahmetfirat24@yahoo.com.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Fırat
authors.forename: Osman
authors.initials: O
authors.lastname: Tecimel
authors.forename: Cetin
authors.initials: C
authors.lastname: Işık
authors.forename: Metin
authors.initials: M
authors.lastname: Ozdemir
authors.forename: Ali
authors.initials: A
authors.lastname: Oçgüder
authors.forename: Murat
authors.initials: M
authors.lastname: Bozkurt
mesh_terms: D000328:Adult; D000368:Aged; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D019468:Disease Management; D004434:Early Ambulation / Q000379:methods; D016267:External Fixators; D005260:Female; D006801:Humans; D018889:Ilizarov Technique / Q000009:adverse effects / Q000295:instrumentation / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D013977:Tibia / Q000000981:diagnostic imaging; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery; D016896:Treatment Outcome