A strategy for the one-stage treatment of open Pilon fractures based on an accelerated rehabilitation surgical concept.

Abstract

Objective: The objective of the study was to study the strategy of one-stage emergency treatment of open Pilon fracture with the concept of accelerated rehabilitation surgery.

Methods: The data of 18 patients with open Pilon fracture treated by first-stage emergency debridement, fracture internal fixation, bone grafting, negative pressure closed drainage covering the wound, leg incision reduction, and second-stage skin grafting or flap transfer in the Department of Orthopedics of our hospital from January 2014 to December 2018 were retrospectively analyzed. Joint surface reduction was evaluated by radiological evaluation criteria such as Burwell-Charnley, fracture healing quality was evaluated by Merchant score, and ankle joint function was evaluated by Tornetta and other criteria at the last follow-up.

Results: All 18 patients were followed up, and the anatomical reduction rate was 94% (17/18) according to radiological evaluation criteria such as Burwell-Charnley. According to Merchant scoring criteria, the fracture healing rate was 83.3% (15/18). At the last follow-up, the ankle function was evaluated according to Tornetta and other criteria, and the excellent rate was 88.9% (16/18).

Conclusions: Using the concept of accelerated rehabilitation surgery to treat open Pilon fractures in the first emergency can effectively avoid soft-tissue complications and is an effective treatment strategy.