title: Prospective Randomized Comparison of Locked Plates Versus Nonlocked Plates for the Treatment of High-Energy Pilon Fractures.
abstract: OBJECTIVE
  To compare the radiographic and functional outcome of patients with high-energy pilon fractures treated with locked versus nonlocked plates.
  
  
  METHODS
  Randomized prospective trial.
  
  
  METHODS
  Academic level 1 trauma center.
  
  
  METHODS
  Between December 2006 and December 2008, 60 consecutive patients with 62 AO/OTA type A, B, and C tibial pilon fractures were enrolled in the study. Thirty-two of the fractures were treated using locked plates and 29 were treated with nonlocked plates. Follow-up data were available for 33 of the 60 patients.
  
  
  METHODS
  Treatment with locked versus nonlocked plates.
  
  
  METHODS
  Short Musculoskeletal Function Assessment (SMFA) questionnaire and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale (AHS). Radiographic measurements on anteroposterior and lateral views for the quality of reduction and maintenance of alignment immediately postoperatively compared with the latest follow-up.
  
  
  RESULTS
  There were no significant differences in the mechanism or injury pattern, average age of the patients, ratio of males to females, tourniquet time, operative time, interval to surgery, AHS, or SMFA scores. One of 15 fractures in the locked plate group lost reduction at the latest follow-up compared with 3 of 19 fractures in the nonlocked group.
  
  
  CONCLUSIONS
  In this study, there seems to be no difference between the 2 constructs. Thus, one must question the routine use of locked plates in the treatment of high-energy pilon fractures.
  
  
  METHODS
  Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Department of Orthopaedic Surgery, University of Cincinnati Medical Center, Cincinnati, OH.
authors.forename: Albert
authors.initials: A
authors.lastname: dʼHeurle
authors.forename: Namdar
authors.initials: N
authors.lastname: Kazemi
authors.forename: Camille
authors.initials: C
authors.lastname: Connelly
authors.forename: John D
authors.initials: JD
authors.lastname: Wyrick
authors.forename: Michael T
authors.initials: MT
authors.lastname: Archdeacon
authors.forename: Theodore T
authors.initials: TT
authors.lastname: Le
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis* / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011474:Prosthesis Design; D020127:Recovery of Function; D013978:Tibial Fractures / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome