Pilon fracture which is defined as a comminuted intraarticular fracture of distal tibia has been
known to be difficult to manage because high axial compression and rotational forces to the
ankle joint result in impaction, severe comminution, metaphyseal disruption, and soft tissue
trauma. Several authors have reported good results using an AO group treatment principle.
However, others have documented less favorable results such as skin slough, wound infection,
and osteomyelitis. Recently, satisfactory results were obtained by the treatment with open
reduction and fixation using Ilizarov method.
We reviewed and analyzed 22 cases of the pilon fracture treated by the two methods O.R.I.
F. and fixation by Ilizarov method) and compared the results to find out the usefulness of
fixation by Ilizarov method, from Feb. 1993 to Mar. 1997 at the Department of Orthopedic
Surgery, Seoul Red Cross Hospital.
Fixation by Ilizarov method using ligamentotaxis and occasional minimal open reduction was
effective for fracture reduction. It also decreased complications such as wound infection, skin
necrosis, and osteomyelitis because it did not need extensive soft tissue dissection. And, it was
also useful for severe comminuted fracture, open fracture, and fracture with extensive
diaphyseal extension to proximal metaphysis.