title: Pathogenesis and Treatment Strategies for Pilon Fractures With Ankle Dislocation.
abstract: The present study investigated the pathogenesis and treatment strategies for pilon fractures with ankle dislocation. A total of 58 patients (47 males and 11 females) who had sustained pilon fractures with ankle dislocation were treated. The mean patient age was 48.1 years. Using the AO classification, 8 cases were type B2, 17 were type B3, and 33 were type C3. The dislocation was medial in 13 cases, lateral in 9, anterior in 11, posterior in 14, and longitudinal in 9. Radiologic examinations were conducted to evaluate the postoperative reduction, dislocation correction, fracture healing, and internal fixation. Ankle function was evaluated according to the Kofoed and Danborg scoring system. The patients were followed up for 4 to 27 months. Anatomic reduction was achieved in 39 cases (67.24%), good reduction in 13 (22.41%), and poor reduction in 6 (10.34%). No internal implant failure occurred, and the fractures had healed after 2 to 4.3 (mean 2.8) months. The rate of good or excellent ankle recovery was 84.00% for those with type B fractures, 75.76% for those with type C, 76.92% for those with medial dislocation, 77.78% for lateral dislocation, 81.82% for anterior dislocation, 78.57% for posterior dislocation, and 81.82% for longitudinal dislocation. Pilon fractures often occur with ankle dislocation in different directions. In such cases, the original anatomy should be restored and the longitudinal alignment recovered to minimize complications as much as possible.
authors.affiliation: Orthopedist, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China.
authors.forename: Zhe
authors.initials: Z
authors.lastname: Song
authors.affiliation: Associate Professor, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China.
authors.forename: Han-Zhong
authors.initials: HZ
authors.lastname: Xue
authors.affiliation: Professor, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China. Electronic address: kunzhangcn@126.com.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Professor, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China.
authors.forename: Zhong
authors.initials: Z
authors.lastname: Li
authors.affiliation: Professor, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhuang
authors.affiliation: Senior Nurse, Department of Orthopaedic Trauma, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi Province, China.
authors.forename: Na
authors.initials: N
authors.lastname: Yang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D015331:Cohort Studies; D016267:External Fixators; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D021621:Imaging, Three-Dimensional; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: 3; ankle dislocation; fracture; internal fixation; pilon fracture