International Journal of Research in Orthopaedics | November-December 2020 | Vol 6 | Issue 6 Page 1145 International Journal of Research in Orthopaedics Lemsanni M et al. Int J Res Orthop. 2020 Nov;6(6):1145-1150 http://www.ijoro.org Original Research Article Outcome of complex tibial pilon fractures definitively treated with external fixator Meryem Lemsanni*, Youssef Najeb, Rachid Chafik, Mohamed Madhar, Hanane Elhaoury INTRODUCTION Complex tibial pilon fractures are usually high energy injuries presenting with significant articular and soft tissue damage. 1,2 The management of such injuries is a surgical challenge, even for experienced orthopedic trauma surgeons. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the ankle joint. 3 Although, in the past, internal fixation has been used commonly, external fixation has become a popular method of treatment in recent years, with a number of publications suggesting that satisfactory results can be obtained. 4,5 In the present study, we aimed to evaluate the radiological and clinical outcomes after the use of external fixation combined with minimally invasive osteosynthesis, as primary and definitive treatment of complex tibial pilon fractures. ABSTRACT Background: Complex tibial pilon fractures are typically sustained with high-energy mechanisms and they are often associated with severe soft tissue compromise that can frequently results in severe complications. The purpose of this prospective case series was to evaluate the radiological and clinical outcomes after the use of external fixation combined with minimally invasive osteosynthesis, as primary and definitive treatment of complex tibial pilon fractures. Methods: A prospective study was undertaken during the period from March 2012 to June 2016. A total number of 109 patients with complex tibial pilon fractures were managed in our institution and included in the study. All the patients were treated with external fixation and minimally invasive osteosynthesis. The mean follow-up period was 47 months (31-60 months). Clinico-radiological progression of fracture union as well as the functional outcome were studied. Results: Eighty fractures resulted from traffic accidents and type 43-C3 fracture according to AO/OTA classification was the most common. Seventy-eight were open fractures and 94 patients had associated distal fibular fractures. All patients were treated with monolateral external fixators for definitive management. The average time to union was 14 weeks (range 9-19). Eleven patients (10%) suffered superficial pin tract infection. One patient developed septic arthritis and evidence of radiological osteoarthritis was present in ten cases (9%) at final follow-up. The American orthopaedic foot and ankle society (AOFAS) score was 84.4±8.1, translating to good clinical results. Conclusions: This review concludes that external fixation, combined with minimally invasive osteosynthesis, consistently produces good functional results without serious complications. Keywords: Pilon fracture, External fixation, Minimally invasive osteosynthesis, High energy mechanism Department of Orthopaedic and Trauma Surgery, Ibn Tofail Hospital, Mohammed VI University Hospital Center, Abdelouahab Derraq Street, Marrakesh, Morocco Received: 13 August 2020 Accepted: 17 September 2020 *Correspondence: Dr. Meryem Lemsanni, E-mail: lemsani.meryam@hotmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20204578