Treatment of AO/OTA Type 43-C3 Pilon Fractures with a Combination of Miniplate and Main Plate: A Retrospective Analysis

Abstract

Background Type-C3 pilon fracture is a distal tibial fracture with a high disability rate that is difficult to treat and has many postoperative complications. Effective treatment of type-C3 pilon fracture remains an important research focus. This study proposed to treat type-C3 pilon fractures with a miniplate combined with a main plate and compared it with the traditional treatment. Methods This study retrospectively analyzed 64 cases of type-C3 pilon fractures treated at our hospital between June 2018 and June 2022, including a miniature steel plate group (MP group, n = 31) and a traditional treatment group (TT group, n = 33). Hospitalization duration, duration of hand surgery, reduction quality, fracture healing, complications, imaging data, and functional scores of the two groups were analyzed. Results The surgery was completed successfully in both groups, and the average follow-up duration was 16.78 ± 3.27 months. There were no significant differences in the duration of preoperative waiting, hospital stay, and weight-bearing between the two groups (P > 0.05). The duration of surgery was significantly shorter in the MP group than in the TT group (P < 0.05). The quality of fracture reduction and healing at 6 weeks after surgery in the MP group was significantly better than that in the TT group (P < 0.05). There was no significant difference in the visual analog scale scores between the two groups. However, at 6 months postoperatively and at the last follow-up, the American Orthopedic Foot and Ankle Society score and ankle fire activity range of motion were significantly better for those in the TT group. There were two cases of ischemic osteonecrosis, two of poor incision healing, and one of severely poor wound healing in the TT group; however, only one patient in the MP group had poor incision healing. Conclusion The use of miniplates combined with main plates in the treatment of type-C3 pilon fracture has obvious advantages, which simplifies the difficulty of the surgery, reduces the volume of the ankle joint, reduces postoperative complications, and is beneficial to postoperative exercise and ankle function recovery.