title: Does external fixation result in superior ankle function than open reduction internal fixation in the management of adult distal tibial plafond fractures?
abstract: BACKGROUND
  Traditionally distal tibial plafond fractures were managed with open reduction internal fixation however, high complication rates have prompted the use of external fixation as an alternative. No definitive review has been conducted and the issue of superior treatment method remains contentious. This review assesses the comparative effectiveness of both with regards ankle function.
  
  
  METHODS
  A search strategy was formulated with keywords ensuring full use of Medical Subject Headings terms for maximum sensitivity with Boolean combinations. Multiple databases were used.
  
  
  RESULTS
  All papers had limitations, hence results and conclusions must be considered conservatively. Paper-1 demonstrated an association between ORIF and superior ankle function (P<0.05). Papers-2 and -3 demonstrated no significant difference (P>0.05) between treatment techniques.
  
  
  CONCLUSIONS
  Neither method can yet be widely advocated as superior with the treatment method chosen remaining primarily on surgeon preference and experience. This review highlights the requirement for further, high-quality research in this area.
authors: Trauma and Orthopaedics Department, University Hospital of Coventry and Warwickshire NHS Trust, Coventry, United Kingdom CV2 2DX. Electronic address: chill295@doctors.net.uk.
authors: Christopher E
authors: CE
authors: Hill
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015601:Injury Severity Score; D057072:Intra-Articular Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016059:Range of Motion, Articular / Q000502:physiology*; D018570:Risk Assessment; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Ankle function; External fixation; Internal fixation; Pilon; Plafond; Tibial