Aim: The pylon tibial fractures are a challenge for the orthopaedic surgeons. The purpose of this study was comparative analysis of different surgical methods of the pylon fractures.

Methods: From 1994 to 2003 143 pylon fractures were treated. There were 87 men and 56 women from 15 to 74 years old. In 45 cases we used only external fixation (Ilizarov apparatus), in 29 open reduction and screw fixation was combined with external fixations. Sixty eight fractures were treated by ORIF according AO principles. In 51 cases “clover leaf” and 1/3 tubular plates were used, in 18 cases stable fixation was realized by LCP-plates. Follow-up results were analyzed through 9 and 12 months.

Results: The good and excellent results (no pain, deformities and good function) were received in 72,7% patients, the satisfactory results – at 23,8 % cases. In 9 patients the superficial and in 4 the deep wound infection took place. The best results are received in cases of Locking Compression Plate (LCP) application.

Conclusions: Full restoration of axis and articular surface (with or without bone grafting), stable fixation and early mobilization of the joint is essential in successful treatment of pylon fractures. Indirect reduction and external fixation can be applied only in A and B1-type of fractures. At types B2,3 and C good results can be received only at use of a stable internal osteosynthesis.