Abstract
Pilon fractures of the distal tibia pose a difficult therapeutic problem. Various treatment methods exist. We present encouraging early results with the Medial Tibial LISS plate (LCDCP) for these injuries.
Materials and Methods: 7 patients (5 male:2 female); age: 34 (range 26–59); All closed injuries 3 type 1; 3 type 2; 1 type IIIc; Average time from injury to surgery: 6 days (4–12 days).
Technique: 4 patients had preliminary joint-spanning fixator; 4 patients had fibular plating through a posterolateral incision; A curved anteromedial incision was used to avoid plate exposure in case of wound breakdown. Medial Tibial LISS plate with inter-fragmentary screws to reduce main fracture fragments. Early, non-weight bearing mobilization.
Results: Minimum Follow Up: 6 months (range 6–18 months). Union was obtained in all fractures. Joint reconstruction was graded as anatomical in 3 patients, mildly non-anatomical in 3 patients, and markedly incongruent in 1 patient (Type IIIc3). ROM: average 10° Dorsiflexion and 30° Plantarflexion. Pain: None in 4, mild in 2, and severe in 1. Wound healing problems: 1 minor requiring no surgical intervention, 1 requiring debridement of distal tibial wound.
We conclude that this technique offers a viable alternative to other methods in the treatment of these difficult injuries.
Correspondence should be addressed to: D. Singh, BOFAS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
