title: [Percutaneous osteosynthesis in tibial pilon fractures. Does the surgical technique determine the final result?].
abstract: OBJECTIVE
  To analyze the outcomes of distal tibia fractures with or without extension into the ankle joint, treated by percutaneous cannulated screws or locking plates.
  
  
  METHODS
  A retrospective study was conducted on 107 patients treated between 2001 and 2012.
  
  
  METHODS
  fractures 43-A and 43-C1 and C2 according to the AO/OTA system, treated with percutaneous osteosynthesis by locking plate or two cannulated screws in X -letter setting. A total of 33 patients were evaluated: 16 tibial fractures were performed with locking plate (G1) and 17 with cannulated screws (G2). Mean time to surgery was 8.31 days (0-14) in G1, and 2 days (0-7) in G2. The mean follow-up was 72 months (12-132). Mean time to healing: 17.08 weeks (8-48) in G1, and 14.56 weeks (8-24) in G2. The results were evaluated according to the AOFAS scale, with plain X-rays, and complications during follow-up.
  
  
  RESULTS
  The mean evaluation according to the AOFAS score was 78.62 in G1 (22-93), and 90.63 in G2 (70-100), and this was statistically significant. In G1, 61.4% (8) of the results were excellent or good, while in G2 it was 76% (13). There were no axial deformity cases or shortenings. There were 4 superficial infections and one broken device recorded in G1.
  
  
  CONCLUSIONS
  The percutaneous cannulated screw fixation is a suitable alternative for the management of fractures without significant joint involvement, and seems to offer better functional results than plates. The shortest time from injury to intervention in this group improves the progress of the soft tissues, and can improve the final result.
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doce de Octubre, Madrid, España. Electronic address: ana_martinfu@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Martín Fuentes
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doce de Octubre, Madrid, España.
authors.forename: E
authors.initials: E
authors.lastname: Sánchez Morata
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doce de Octubre, Madrid, España.
authors.forename: M
authors.initials: M
authors.lastname: Mellado Romero
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doce de Octubre, Madrid, España.
authors.forename: B
authors.initials: B
authors.lastname: Bravo Giménez
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Doce de Octubre, Madrid, España.
authors.forename: J
authors.initials: J
authors.lastname: Vilà y Rico
mesh_terms: D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cannulated screw; Locking plate; Osteosíntesis percutánea; Percutaneous osteosynthesis; Pilón tibial; Placa bloqueada; Tibial pilon; Tornillo canulado