title: [360 degrees INTERNAL FIXATION BY DOUBLE APPROACHES FOR HIGH-ENERGY CLOSED Pilon FRACTURES].
abstract: OBJECTIVE
  To observe the effectiveness of 360 degrees internal fixation by anteromedial and posterior-lateral approaches for high-energy closed Pilon fractures.
  
  
  METHODS
  Between February 2013 and February 2015, 18 cases of high-energy closed Pilon fractures were treated. There were 11 males and 7 females with an average age of 40.5 years (range, 20-65 years). The causes were falling injury in 10 cases and traffic accident injury in 8 cases. All fractures were Rüedi-Allgower type III Pilon fracture combined with ipsilateral fibula fracture. The average interval from injury to operation was 8 days (range, 5-13 days). Reduction of fracture was performed by anteromedial and posterior-lateral approaches and the fracture fragments were fixed by 360 degrees internal fixation. The effectiveness was assessed by ankle X-ray film and Mazur score at last follow-up.
  
  
  RESULTS
  Two cases had skin necrosis and received flap surgery, the other cases obtained primary healing of incision. All the cases were followed up 11.2 months on average (range, 3-27 months). X-ray film showed that all fractures healed at 3-4 months after operation (mean, 3.6 months). No deep infection or plate exposure occurred. According to Mazur score, the results were excellent in 8 cases, good in 7 cases, fair in 2 cases, and poor in 1 case, and the excellent and good rate was 83.3%.
  
  
  CONCLUSIONS
  The effectiveness of the 360 degrees internal fixation for treatment of high-energy closed Pilon fractures has the advantages of reliable fixation, early functional exercise, and good functional recovery of the ankle joint.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Chen
authors.forename: Dan
authors.initials: D
authors.lastname: Chen
authors.forename: Haiqing
authors.initials: H
authors.lastname: Yang
authors.forename: Wente
authors.initials: W
authors.lastname: Wu
authors.forename: Zhu
authors.initials: Z
authors.lastname: Dai
mesh_terms: D064386:Ankle Fractures / Q000601:surgery*; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D000843:Ankle Joint; D001860:Bone Plates; D003646:Debridement / Q000379:methods; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D005597:Fractures, Open / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012189:Retrospective Studies; D013524:Surgical Flaps; D013639:Tarsal Bones; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing