![]() The posterior pilon fracture line is mostly coronal, with step production, longitudinal displacement of the articular surface, and easy entrapment of articular cartilage and soft tissue. However, the best treatment for posterior pilon fracture is a matter of opinion. ![]() Currently, there are many surgical approaches for posterior pilon fractures, such as the posterolateral approach, the posterior-medial approach, or the modified posterior-medial approach. Our team believes that posterior pilon fractures involve the posterior articular surface of the distal tibia and that anatomic repositioning is mandatory. The interest of foot and ankle scholars in posterior pilon fractures has grown since the concept of posterior pilon fractures was introduced. The prognosis is not as good as for posterior ankle fractures due to the large area of involvement of the posterior articular surface of the distal tibia. Posterior pilon fractures are produced by vertically and rotational stresses on the foot in plantar flexion and are characterized by major fracture mass on the posterior side, a coronal fracture line, and the possible inclusion of a die-punch bone mass. The energy tends to be less than that of pilon fracture, and the soft tissue condition is superior to that of pilon fracture. In contrast, posterior pilon fractures are the result of a combination of vertical and rotational violence and involve only the posterior articular surface of the distal tibia. Pilon fracture is a compression fracture of the entire distal tibial articular surface caused by high energy vertical violence. Trial registration: Retrospective registration. The trans-fibular fracture approach provides a better surgical option for specific types of posterior pilon fractures with a high rate of anatomic repositioning and a good near-term outcome. At the final follow-up, the AOFAS functional score of the open fibula fracture line group was statistically superior to that of the conventional posterolateral group ( p 0.05). There were no statistically significant differences between the two groups in terms of fracture healing time and time to full weight bearing ( p > 0.05). 71%, p = 0.406), but there was no statistically significant difference between the two groups. The overall anatomic reduction rate was slightly better in the open fibula fracture line group than in the conventional posterolateral group (81% vs. ![]() The clinical outcomes were evaluated using American Orthopaedic Foot & Ankle Society ankle-hind foot score (AOFAS) and visual analog score (VAS). We used the Burwell-Charnley scale to assess the effectiveness of surgical repositioning. Thirty-one cases were included in the open fibula fracture line technique group and twenty-eight cases were included in the traditional posterolateral approach group. MethodsĪ retrospective analysis of patients with posterior pilon fractures treated using the open fibula fracture line technique and the traditional posterolateral approach between January 2015 and March 2020. The purpose of this retrospective study was to compare the clinical and imaging outcomes of pilon fractures after treatment with the open fibula fracture line (OFFL) surgical technique versus the traditional posterolateral approach (TPL). The surgical approach and technique for the treatment of posterior pilon fractures are still controversial. Currently, this form of fracture is receiving increasing attention. Posterior pilon fracture is a relatively common clinical fracture involving the posterior articular surface of the distal tibia.
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