Fibular fixation may be unnecessary for pilon fracture reconstruction
Results of this retrospective case-control study indicate fibular fixation is unnecessary for all patients who sustain plafond fractures with metadiaphyseal dissociation, and this practice may lead to increased rates of plate removal.
John C. Kurylo, MD, and his colleagues studied data for 111 patients with high-energy complex plafond fractures with metadiaphyseal dissociation. Of the 93 patients who underwent open reduction and internal fixation of the tibia, investigators categorized the patients into the following groups to determine the impact of fibular fixation: 26 patients with fixed fibula fractures, 37 patients without fibular fixation and 30 patients without fibula fractures.
Results showed no difference between patients with fibula fractures treated with ORIF of the tibia with regards to fibula fracture type and location; however fibula fractures were observed in all patients with open fractures.
Fibular fixation was performed in 11 of the 26 patients at an average of 17 days due to inability to hold length and alignment. Fifteen patients were treated with augment fixation due to poor bone stock and to assist with the reduction. Postoperative and final alignment were not different between patients with fibula fractures vs. patients without fibula fractures, according to researchers.
A comparison of the study groups revealed the only statistical significance between the two groups was patients with fibula fixation needed implant removal.‒ by Monica Jaramillo
Disclosures: Kurylo reports no relevant financial disclosures. Please see the full study for a full list of all other authors’ relevant financial disclosures.