LCP Anterolateral Distal Tibia Plate for Treatment of Complex Pilon Fractures at a Delayed-stage

Objective:To detect the curative effect of delayed open reduction and "L"-shaped LCP anterolateral distal tibia plate for treating of complex Pilon fractures.Methods:A total of 30 cases of Pilon fractures were treated by open reduction and "L"-shaped LCP anterolateral distal tibia plate after improvement of soft tissue conditions.All the cases were type C fracture according to AO classification,7 cases of which were type C1,15 cases were type C2,and 8 cases were type C3.There were 6 cases of open Pilon fractures and 24 cases of closed fractures.Operations were performed on average 10.5 days after the injuries(range 7 to 14 days).Results:All the patients were followed-up for 14 months to 28 months(18.5 months averagely).The average healing times was 12 to 23 months(14.3 months averagely).There were 2 cases of wound infection,3 cases of cutaneous necrosis,and 5 cases of delayed bone healing,including two cases of bone grafting surgery again.There was also one case of malunion due to early weight-bearing.According to score system of American Foot and Ankle Society(AOFAS),there were 18 cases in excellent,9 cases in good,and 3 cases in fair.The rate of excellent and good was 90%.Conclusion:It is important to select the right surgical method and time for treating patients of severe Pilon fractures depending on type of fractures and degree of soft tissue injury.Extended open reduction combined with "L"-shaped LCP anterolateral distal tibia plate is ideal method in treatment of complex Pilon fractures.