Timing of Surgery for a Tibial Pilon Fractures – Search for a Wise Moment

Ilir Hasani

doi:10.3889/oamjms.2020.4249

Authors

Ilir Hasani University Clinic for Traumatology, Orthopaedic Diseases, Anaesthesia, Reanimation, Intensive Care and Emergency Centre – Skopje, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2020.4249

Keywords:

pilon, biphasic treatment, surgery, functional outcome

Abstract

BACKGROUND: Biphasic treatment of pilon fractures has been accepted as standard modality of care.

AIM: The aim of the present study was to evaluate the effect of timing of definitive surgery for closed pilon fractures on the short-term functional outcome.

MATERIALS AND METHODS: Prospective study focused the patients suffering pilon fracture that has undergone treatment in a biphasic manner. Initially, spanning external fixator was applied, while the definitive osteosynthesis was performed within the next several days, in accordance with surgeon’s knowledge. The final functional outcome was evaluated using the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Score.

RESULTS: Forty-two patients were included in the study. Mean time passed from injury to definitive surgery was 11.0 ± 3.4 days. Mean value of the functional score was 86.54 ± 13.2 points, with no significant differences with regard to the demographics and injury features. Pearson correlation coefficient demonstrated negative significant correlation between timing of definitive surgery and functional outcome (r = −0.428, p = 0.033). Complications were noted in 16% of the patients.

CONCLUSION: Definitive surgery should be planned as soon as possible, once the surgeon considers the soft-tissue status acceptable for surgery. Injudicious postponing has a negative effect on the short-term functional outcome.

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