ABSTRACT
Background: treatment of pilon fractures is challenging and the appropriate method is still uncertain.
Purpose: detection of the best modality for the treatment of pilon fractures
Patients and Methods: This prospective study was conducted on 40 patients with pilon fractures. The patients were subdivided into 3 groups; Group A: 12 patients underwent two staged techniques (temporary DFF followed by later ORIF), and Group B: 8 patients underwent one-stage fixation with primary IF. Group C: 20 patients underwent one-stage fixation with Primary ORIF. The mean follow-up time is 12 (10-17) months.
Results: The adequacy of anatomical reduction was significantly higher in group C than in groups A and B. The union rate was 97.5%. The union time was insignificantly different between the studied groups. Conclusion: One-stage surgery using the Ilizarov fixator is the best treatment for all open and closed type RA III pilon fractures and is more successful than one-step ORIF surgery due to the potential for wound complications. One-stage surgery using ORIF is the ideal option for closed pilon fracture RA I and II with mild oedema. Two-stage surgery is reliable for open fracture RA I and III.