title: Surgical approach in difficult tibial pilon fractures.
abstract: OBJECTIVE
  The aim of the present study is to emphasize the optimal moment and approach for tibial pilon complex fractures and their complications.
  
  
  METHODS
  We have investigated and treated 7 patients with complex fractures of the tibial pilon with tendencies to complications. According to AO classification,we have recorded 4 fractures type 43C2 AO, 2 fractures type 43C3 AO (with one open fracture type IIIA Gustilo) and 1 fracture type 43B3 AO. According to soft tissue status, surgical treatment was performed by a one-step or two-step approach.
  
  
  RESULTS
  All fractures healed after an interval of 13.6 weeks(range 8-28 weeks) with one delayed consolidation. The open fracture was complicated by posttraumatic arthrosis. No infections or implant failures were recorded. According toOvadia score, objective and subjective evolution showed good results in 5 cases, one excellent result and one poor result.
  
  
  CONCLUSIONS
  Fracture type and the soft tissue status are crucial for the results of operated fractures. These arguments determine the application of one-step or two-step surgical procedure as well as optimal implant choice.
authors: B
authors: B
authors: Puha
authors: T
authors: T
authors: Petreuş
authors: G
authors: G
authors: Berea
authors: P D
authors: PD
authors: Sîrbu
authors: G
authors: G
authors: Puha
authors: O
authors: O
authors: Alexa
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016267:External Fixators; D005593:Fracture Fixation, Internal / Q000379:methods; D005596:Fractures, Closed / Q000000981:diagnostic imaging / Q000601:surgery*; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D015601:Injury Severity Score; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular; D013530:Surgical Wound Infection / Q000517:prevention & control / Q000628:therapy; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing