Early Versus Delayed Plate Fixation in Pilon Fractures-Which Is More Advantageous?
Küçük Resim Yok
Tarih
2026
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Mdpi
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background: Pilon fractures refer to distal tibial fractures that may involve extra-articular, partial articular, or complete intra-articular components, most commonly caused by high-energy trauma. The choice between early (<72 h) and delayed (>7 days) surgical fixation significantly impacts clinical outcomes. This study aimed to compare the effects of early vs. delayed plate fixation on fracture healing time, functional outcomes, and complication rates. Materials and Methods: This retrospective study analyzed 80 patients who underwent surgical treatment for pilon fractures between 2018 and 2023. Patients were divided into two groups: early surgery (<72 h, n = 40) and delayed surgery (>7 days, n = 40). Additionally, patients were categorized based on the fixation method: single-plate fixation (n = 40) and double-plate fixation (n = 40). Outcome measures included fracture healing time (weeks), defined as cortical continuity on radiographs; functional outcomes (AOFAS score); and complication rates (infection, malunion, and implant failure). Results: Shorter healing time was observed in the early surgery group (14.2 vs. 16.8 weeks, p < 0.05). Better functional outcomes were recorded in the early surgery group (AOFAS score: 82.3 +/- 6.5 vs. 78.1 +/- 7.2, p < 0.05). Lower infection rates were noted in the delayed surgery group (7.5% vs. 12.5%, p < 0.05). Double-plate fixation provided better mechanical stability but resulted in higher soft tissue complication rates. Single-plate fixation preserved soft tissue integrity but had higher malunion and implant failure rates. Conclusions: Early surgery is associated with shorter healing time and better functional outcomes, but increased soft tissue complications require careful management. Delayed surgery offers a safer approach for soft tissue healing but may prolong functional recovery. While double-plate fixation ensures greater stability, it may increase soft tissue morbidity, whereas single-plate fixation reduces soft tissue complications but may compromise stability. A personalized surgical approach is recommended for optimal outcomes in pilon fracture management.
Açıklama
Anahtar Kelimeler
Pilon Fractures, Early Surgery, Delayed Surgery, Soft Tissue Management
Kaynak
Journal of the American Podiatric Medical Association
WoS Q Değeri
Q4
Scopus Q Değeri
Q3
Cilt
116
Sayı
2
