Is Pain Inevitable after Tibia Pilon Fractures?: A 3-Year Prospective Analysis.

Abstract

Background: Tibia pilon fractures are associated with a low rate of pain-free return to normal life. Our objective was to ascertain the prevalence of chronic pain in the extensive postoperative follow-up of pilon fractures. Additionally, the factors affecting the existence and intensity of pain were investigated.

Methods: This prospective cohort study analyzed 85 patients, with a mean follow-up of 32.98 months (range, 24-65), treated with single-staged surgery between 2015 and 2019. The analyzed parameters were as follows: demographic data, injury mechanisms, fracture type, operation type, preferred main incision and implant, whether posterolateral incision and implant are used, whether the patient can be operated on within the first 48 hours after admission, follow-up period, and complications. Patients' pain occurrence and intensity were questioned using the Stanmore Functional Scale.

Results: During the final follow-up, only 18 (21.2%) patients reported that they returned to pain-free normal life. The choice of implant and incision was found to be significantly related to both the occurrence and the severity of pain (P < .05). Furthermore, the severity of pain was also found to be significantly related to fracture type and posterolateral incision (P < .05).

Conclusions: When treating pilon fractures, postoperative pain should be considered as a parameter. Dual-plating has been linked to long-term pain after pilon fractures and this should be kept in mind when creating a treatment plan.