Limited Open Reduction and Fixation by Ankle-Spanning Ilizarov Fixator in High Energy Pilon Fractures

Abstract

Background: High-energy pilon fractures were intricate ankle injuries that contrast with standard ankle fractures. Their management poses considerable difficulties for orthopedic surgeons, especially due to the frequent presence of extensive soft tissue damage. Despite the multitude of potential treatment alternatives, the unique characteristics of each injury complicate the endorsement of a unique standard methodology. To see the outcome of high energy pilon fractures treated by limited open reduction combined with Ilizarov external fixator.

Materials and methods: This prospective observational study was conducted in National Institute of Traumatology and Orthopaedic Rehabilitation (NITOR) Dhaka. Data were collected during the period from May 2017 to August 2019. Thirty-two patients with AO/OTA type C pilon fractures were included. Initial soft tissue injury was managed by calcaneal traction on a Braun-Bohler frame. Following the management of soft tissues, fixation done by limited open reduction and ankle spanning Ilizarov fixator. The outcome measures included restoration of joint congruence, pin tract infection, wound infection, osteomyelitis, union, malunion, nonunion, ankle joint function etc. Data were analyzed using Statistical Package for Social Science (SPSS) 20.0.

Results: The patients were followed for an average of 18 months (Range 4-29). Fracture healing was observed in all patients, and the mean fracture healing time was 16 weeks (Range 14-20). No major wound complications were observed. Pin site infection was observed in 8 cases that resolved with local wound care. Chronic osteomyelitis with ring sequestrum was developed in one patient. Except for 1 case that developed an angular deformity, no loss of reduction was observed. According to AOFAS scoring system, the average ankle-hindfoot score was 77 (Range 39-98)

Conclusion: With minimum complication and good healing results, fixation by limited open reduction and ankle spanning Ilizarov fixator was particularly useful for high energy pilon fractures.

 JBRMC, Volume 08   Issue 02  July 2026 ; 10-14