Abstract
In the present study, we explored the effectiveness and complications of omnidirectional
internal fixation using a double approach for treating Rüedi-Allgöwer type III pilon
fractures. A retrospective analysis was performed of 19 cases of Rüedi-Allgöwer type
III unilateral closed pilon fracture. With preoperative preparation and correct surgical
timing, the reduction was performed using anteromedial and posterolateral approaches,
and the fracture fragments were fixed by omnidirectional internal fixation. Imaging
evaluation was performed using the Burwell-Charnley scoring system. The Johner-Wruhs
scoring system was used to assess the functional status of the patients. A comprehensive
evaluation of efficacy was performed using a 5-point Likert score. The complications
were also recorded and analyzed. All patients were followed up for an average of 16.2 months.
The operative incisions of 15 cases healed by primary intent and with delayed healing
in 4. All patients had achieved bony union at an average of 16 weeks postoperatively.
No deep infection, broken nail or withdrawn nail, exposed plate, or skin flap necrosis
occurred. The Burwell-Charnley imaging evaluation showed that 14 patients had anatomic
reduction of the articular surface and 5 had acceptable reduction. Using the Johner-Wruhs
scoring system, the results were excellent for 8, good for 7, fair for 2, and poor
for 2 patients; the combined rate of excellent and good results was 78.9%. The Likert
score of efficacy self-reported by the patients was 3 to 4 points for 12 patients,
2 points for 4 patients, and 0 to 1 point for 3 patients. The Likert score of therapeutic
efficacy reported by the physicians was 3 to 4 points for 10 patients, 2 points for
5 patients, and 0 to 1 point for 4 patients. Omnidirectional internal fixation using
double approaches was an effective method to treat Rüedi-Allgöwer type III pilon fractures
with satisfactory reduction and rigid fixation, good joint function recovery, and
few complications.
Level of Clinical Evidence
Keywords
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Article info
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
