Surgical treatment of Complex Pilon Fracture by Open Reduction and Internal Fixation Versus External Ilizarov / Mohammed Mohammed Khairy Ahmed ; Supervised Ashraf Abdelkader Alnahal , Hisham Mesbah Soliman , Ahmed Hazem Abdelazeem

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Orthopaedic Surgery

This study demonstrates that the external fixator ilizarov versus locked plate, is a reasonable and viable option in the treatment of severe distal tibia fractures, especially those with soft-tissue or bony compromise (complex fracture). Satisfactory reduction was possible through closed or open approaches. Excellent to good results were obtained in over 70% in patients with distal tibial fractures (pilon fracture). Healing occurred mostly without bone-grafting. There were few complications,most of these complications were minor and did not affect final outcome. The results of the current study no significant difference both groups in clinical and radiological results in short term follow up Analysis of the current result according to AOFAS score show marked improvement in both group after pilon fixation by ilizarov 89.75 mean at latest visit or locked plate89.85 mean at latest visit . Based on the current study, AOFAS in ilizarov(20 patient) methods has 12 excellent, 4 good, 3 fair, 1 poor and in plate(20 patient) methods has 10 excellent, 5 good, 4 fair, 1 poor.the surgeon should understand that the severity of the soft tissue injury cannot be separated from the degree of skeletal involvement. There is no evidence in the literature to indicate which methods is better, only in sever soft tissue injury ilizarov is superior on locked plate in our study as the most other literature. We did not record any case of revision, deep infection and metal failure

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