Abstract
Purpose
Pilon fracture is a severe injury which has a great impact on the patients' lives, but in what extend is not clear yet in the literature. The purpose of this study was to investigate the gait alternations after treatment of patients who had pilon fractures.
Materials & Methods
We have evaluated the gait pattern of patients who were treated with circular Ilizarov frame following pilon fractures in our department. The gait was tested by using a force plate in a walking platform. Ground Reaction Forces (GRF) and timing of gait phases data were collected during level walking at self-selected speeds. The patients performed two walking tasks for each limb and the collected data were averaged for each limb. Demographic, clinical, radiological, trauma outcome (COST) and quality of life questionnaire (SF-12) data were also collected.
Results
We have analysed the gait through the GRF of twelve patients (aged 44.9 ±12.4 years), who had undergone treatment with circular Ilizarov frame following pilon fractures (67% were male). The tests were performed at an average of 10.5 months after the initial treatment. SF-12 Mental scores have returned to normal (mean 56.4 ±11.6) but physical scores remained impaired (mean 41.8 ±8.4). COST questionnaire scores reached average levels (47.1 ±15) in all dimensions (Symptoms: 51.4 ±16, Function: 44 ±14 and Mental Status: 56.6 ±16). During the push-off phase all the plantar flexor muscles are activated and the ankle plantar flexes to achieve the push off. It seems that this motion, is not achieved adequately with the affected limb and the patients are using their normal limb earlier (pre-swing is the start of the double support of the gait) in order to progress in their gait circle.
Conclusions
Ten months following treatment with circular ilizarov frame for pilon fracture the patients still have impaired gait pattern. The differences can be explained by the lack of plantar flexion of the ankle which results to poorer push-off of the affected limb.
