title: The management of tibial pilon fractures with the Ilizarov fixator: The role of ankle arthroscopy.
abstract: BACKGROUND
  Pilon fractures usually result from high energy trauma, and are commonly associated with extensive soft tissue damage which prevents the use of open reduction and internal fixation.
  
  
  OBJECTIVE
  This study was designed to evaluate the use of the Ilizarov external fixator in the treatment of pilon fractures of the ankle, and to determine whether arthroscopy of the ankle could improve the outcome.
  
  
  METHODS
  From February 2011 to May 2013 a total of 23 patients with unilateral closed pilon fractures were divided into two groups treated with and without arthroscopy during fixation with the Ilizarov external fixator. The fractures were classified according to the AO Rüdi and Allgőwer classification. Follow up ranged from 10 to 37 months with a mean of 18 months.
  
  
  RESULTS
  All cases were evaluated at follow up by the AOFAS and the Bone et al. grading system. According to Bone et al. there were 3 cases excellent, 4 cases good, 2 cases fair, and 2 cases poor in Group A (without arthroscopy), whereas there were 4 cases excellent, 6 cases good, 2 cases fair in Group B (with arthroscopy). The AOFAS score for Group A was 77.8±5.8, and for Group B was 78.4±6.9.
  
  
  CONCLUSIONS
  We concluded that the Ilizarov external fixator is an excellent method in treating pilon fractures as it minimizes the need for extensive surgery. We also conclude that the use of arthroscopy during pilon fracture fixation did not add statistically significant improvement to our results and it needs longer term investigation to assess its advantage - if any - to the final outcome.
  
  
  METHODS
  level 2.
authors.affiliation: Mansoura University Hospital, Mansoura Faculty of Medicine, Elgomhoria Street, Mansoura 35516, Aldakhlia, Egypt. Electronic address: hanielmowafi@yahoo.com.
authors.forename: Hani
authors.initials: H
authors.lastname: El-Mowafi
authors.affiliation: Mansoura University Hospital, Mansoura Faculty of Medicine, Elgomhoria Street, Mansoura 35516, Aldakhlia, Egypt.
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Hawary
authors.affiliation: Mansoura University Hospital, Mansoura Faculty of Medicine, Elgomhoria Street, Mansoura 35516, Aldakhlia, Egypt.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Kandil
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D000843:Ankle Joint / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D001182:Arthroscopy / Q000379:methods*; D004867:Equipment Design; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005597:Fractures, Open / Q000601:surgery; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D008297:Male; D011446:Prospective Studies; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Ankle arthroscopy; Ilizarov external fixator; Pilon fracture