The Clinical Research Of Pilon Fracture Of Rüedi-Allg(?)wer Type Ⅲ By Internal Fixation With Double Plates

Objective: To explore the technique and results of internal fixation with double plates in treatment of Pilon fracture of Ruedi-Allgower typeâ…¢.Methods: From February 2000 to February 2007, 78 cases with Pilon fracture classified as Ruedi-Allgower typeâ…¢were evaluated retrospectively. All the patients were treated in department of the orthopaedics of the 175th hospital of PLA. All cases were divided into cure group and control group (cure group had 36 cases, control group had 42 cases). The cure group were treated by internal fixation with double plates. The control group only used tradition open reduction and internal fixation. Clinical results, quality of reduction of the articular surface, time for bone union, post-operative complications were compared respectively between two groups.Results: The follow-ups ranged from 12 to 18 months with an average of 15.1 months. Tornetta's criteria for clinical results and Burwell-Charnley's radiographic criteria of reduction have been used for evaluation of the treatment of the Pilon fracture. There was no case of difficult of incision suturation and deep infection. The rates of necrosis of skin were 11.11% in cure group and 7.14% in control group(p>0.05), the rates of superficial infection were 13.89% in cure group and 9.52% in control group(p>0.05), there was no significant difference between two groups. The excellent rates of clinical results were 86.11% in cure group and 66.67% in control group(p<0.05), the rates of anatomical reduction of the articular surface were 77.78% in cure group and 45.24% in control group(p<0.05), the rates of normal bone union were 94.44% in cure group and 78.57% in control group(p<0.05), the rates of anchylosis were 11.11% in cure group and 42.85% in control group(p<0.05), the rates of malunion were 5.56% in cure group and 26.19% in control group(p<0.05), the rates of traumatic osteoarthritis were 11.11% in cure group and 30.95% in control group(p<0.05), there were significant differences between two groups, curative effect of cure group is better than that of control group and complications of cure group is less than that of control group.Conclusion: In the treatment of Pilon fracture of Ruedi-Allgower typeâ…¢, the internal fixation with double plates can help to enable early ankle joint motion, and can prevent anchylosis, malunion, delayed union, nonunion and traumatic osteoarthritis. The method is effective to recover the function of ankle joint.