Comparison of Functional and Radiologic Outcomes of Pilon Fractures Treated with Ilizarov External Fixator and Minimally Invasive Plate Osteosynthesis

INTRODUCTION: Pilon fractures involve the distal articular surface of the tibia. Gold standard surgical treatment remains controversial for pilon fractures. The purpose of this retrospective study was to compare the mid-term outcomes of tibial pilon fractures that were treated with the Ilizarov external fixator and Minimally Invasive Plate Osteosynthesis.
METHODS: Fifty patients included in the study with a minimum of 12 months follow-up. Patients divided into two groups according to the treatment method. The first group consisted of patients with the Ilizarov external fixator, and the second group was with MIPO. The American Orthopaedic Foot and Ankle Society (AOFAS) score, the Foot and Ankle Disability Index (FADI) and Visual Analogue Scale (VAS) score were used in the evaluation of functional outcomes. Ankle and subtalar joint range of motion (ROM) were evaluated at the last follow-up. The association between reduction quality and the development of ankle OA was analysed as well.
RESULTS: There was no significant difference between the two groups regarding AOFAS, FADI, and VAS scores (P>0.05). There was also no significant difference between groups regarding ankle ROM in the last follow-up (P=0.10). Also, there was no significant difference between the two groups regarding union rates and complications (p=0.22).
DISCUSSION AND CONCLUSION: Both MIPO and the Ilizarov techniques are effective and safe methods with low complication rates in the treatment of pilon fractures. Using definitive Ilizarov external fixation technique leads to lower treatment costs.