Analysis the Curative Effect of One-Third Steel Plate Applied in the Medial Column of Pilon Fracture

Objective: To analysis the difference of efficacy between the one-third tube steel plate and screw on the medial column of Ruedi-Augower III pilon fracture. Methods: The clinical data of 26 patients with Ruedi-Augower type III pilon fractures admitted from April 2016 to April 2019 were collected. Patients were divided into two groups according to the reconstruction materials. In the control group, 16 cases were fixed with screws on the medial column. In the observation group, 10 cases were reconstructed with a one-third tube steel plate on the medial column. The reduction quality was evaluated by using Burwell–Charnley’s radiographic criteria. Ankle function was evaluated by using the American Orthopedic Foot and Ankle Society (AOFAS) ankle-hindfoot score. The preoperative swelling time, operation time, intraoperative blood loss, fracture healing time, postoperative weight-bearing time, postoperative AOFAS ankle-hindfoot score and postoperative Burwell-Charley Radiology Score were compared between the two groups. Results: In the all patients, nobody developed deep tissue infections. The fracture healing time was 15.07±0.93 weeks, and the weight-bearing time after the operation was 6.91±0.58 weeks. The satisfactory rate was 90.00% according to Burwell–Charnley’s reduction criteria and the second month postoperative AOFAS ankle-hindfoot score was 66.30±2.79.As for the control group, the fracture healing time was 15.83±0.56 weeks, and the postoperative weight-bearing time was 8.60±0.50 weeks. Only 70% fractures accomplished anatomic reduction on the basis of Burwell–Charnley’s reduction criteria and the AOFAS ankle-hindfoot score only got 75.80±1.94 in the second month after surgery. Conclusion: When Ruedi-Augower type III pilon fractures were treated with one-third tube steel plate in the medial column, compared with the simple screw fixation, it took into account the excellent healing of soft tissues meanwhile it promised the weight-bearing time earlier and less loss rate of long-term postoperative reduction.