title: Open reduction and internal fixation of posterior pilon fractures with buttress plate.
abstract: OBJECTIVE
  Posterior pilon fractures are rare injuries and have not yet gained well recognition. The purpose of this study was to present the treatment outcome for patients with posterior pilon fractures treated with buttress plate.
  
  
  METHODS
  In this retrospective study we identified patients with posterior pilon fractures of the distal tibia who had undergone open reduction and internal fixation at our institute. Between January 2007 and December 2009, 10 patients (mean age, 46.5 years) who had undergone buttress plating via either a posterolateral approach or a dual posterolateral-posteromedial approach, were selected. All 10 patients were available for follow-up. The clinical outcome was evaluated with the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and the visual analogue scale (VAS). The radiological evaluation was performed using the osteoarthritis-score (OA-score).
  
  
  RESULTS
  Satisfactory reduction and stable fixation were accomplished in all patients. At a mean follow-up of 36.2 months, all patients had good radiological results and showed satisfactory clinical recovery. The mean AOFAS sore was 87.8, the mean OA-score was 0.6, and the mean VAS scores during rest, active motion, and weight-bearing walking were 0.6, 0.8, and 1.4, respectively.
  
  
  CONCLUSIONS
  Buttress plating for posterior pilon fractures gave satisfactory clinical outcomes. It also ensured rigid fixation which in turn enabled earlier postoperative mobilization. Level of Evidence IV, Retrospective Study.
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Chen
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Li
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Ashwin
authors.initials: A
authors.lastname: Aubeeluck
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Yun-Feng
authors.initials: YF
authors.lastname: Yang
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Jia-Qian
authors.initials: JQ
authors.lastname: Zhou
authors.affiliation: Tongji University , School of Medicine, Shanghai, China, Department of Orthopaedics, Tongji Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Guang-Rong
authors.initials: GR
authors.lastname: Yu
keywords: Ankle injuries; Bone plates; Internal fixators; Tibial fractures