Impact of the fibula fractures and syndesmotic injuries on the prognosis of the tibial pilon fractures
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Aim: To evaluate tibial pilon fractures, as well as the type of fi bula fracture, and the presence of injury to the inferior tibiofi bular joint. Materials and methods: Th e study included 42 patients (34 male, 8 female) who underwent surgery for pilon fractures and were followed up. Th e mean follow-up period of the patients was 72 months (range: 36-102 months). Th e patients were classifi ed into 2 groups as Ruedi-Allgower (RA) Type II, including 20 patients and RA Type III, including 22 patients. Th e fi bula fractures of the patients were classifi ed according to the Weber classifi cation. Th e reduction quality was determined by evaluating the early postoperative graphs of the patients based on the scale defi ned by Conroy et al. Th e standard anterior-posterior and side graphs were investigated for arthrosis. Th e clinical evaluation of the ankles of the patients was based on the rating scale of Teeny and Wiss. Results: In the RA Type II group, Weber B fi bular fractures were signifi cantly more common and, in the RA Type III group, Weber C fi bular fractures were signifi cantly more common (P < 0.001). Comparisons of the fi bular fracture types revealed that in Weber Type C fractures, the incidence of posttraumatic arthrosis was higher (P < 0.05). Th e clinical evaluations recorded on the fi nal controls of the patients showed that suffi cient outcome was achieved in 55% of the patients with RA Type II fractures and in 45.5% of the patients with the RA Type III fractures. Conclusion: Th e type of fi bular fracture and the presence of syndesmotic injury aff ect the functional outcome of pilon fractures.