Observation Of Recent Cure Effects Of Pilon Fractures Treated With Dynamic External Fixation

Objective:Application of Dynamic external fixation and limited internal fixation to Ruedi-AllgowerⅡ\Ⅲtype Pilon fractures and to assess its efficacy, provide the basis in choice for the treatment of complex Pilon fracture in clinical.Methods:A prospective randomized controlled study, selected according to diagnostic criteria, inclusion criteria without exclusion criteria 44 patients were randomly divided into 2 groups, treatment group (Group A) was treated by manipulative reduction of FoShan hospital of TCM, external fixator and limited internal fixation;The contorl group (Group B)was treated by open reduction and locked plate fixation. Operation time and postoperative complications including early and later period the two groups were observed and compared, Acounted and evaluated the rang of motion in different periods of ankle, image radiographic grade, healing time and Mazur score.Results:44 patients were followed up, lost one lost in Group A, Group B two, one dead in car accident,40 patients have completly follow-up datas. All patients were followed up for 24-52 weeks, average 32.7 weeks. The operating time of Group A was 76.86±8.82min, Group B 89.74±10.84min, there was statistically significant (P<0.05). The ankle dorsiflexion activity of Group A after operation 24 weeks was 12.61±4.05°, Group B was 10.14±3.79°there was statistically significant (P<0.05); The ankle joint plantarflexion activity of Group A after operation 24 weeks was 24.90±4.29°,Group B was 21.79±5.76°, there was no statistically significant (P<0.05). The rate of fine and good in the Burwell-Charnley radiological evaluation Postoperative of Group A was 95.2%, Group B was 89.5%, there was no significant difference (P> 0.05). The healing time of Group A was 15.52±2.84 weeks, Group B was 15.32±3.38 weeks, there was no significant difference (P> 0.05). The Mazur ankle function score 4 weeks after operation of Group A was 48.84±5.23, Group B was 47.67±5.96, there was no statistical significance (P> 0.05); After 12 weeks, Group A's Mazur score was 73.37±5.56, Group B was 72.43±5.19, there was no statistical significance (P> 0.05); The Mazur ankle function score 24 weeks after operation of Group A 88.71±4.71, Group B was 87.62±5.51, there was no statistical significance between the two (P> 0.05)Conclusion:The two groups in early and later complications (superficial infection excluded), the range of ankle, fracture reduction imaging score, healing time, Mazur ankle function system score were found no significant difference. However, Group A has significant andvantage in superficial wound infection rate and ankle dorsiflexion activity compared with group B, Which can be certified Dynamic external fixation and limited internal fixation is a good treatment of complex fractures of Pilon.