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No significant differences found in outcomes of locked vs non-locked plates for pilon fractures
Results of this prospective randomized study showed comparable complication rates, function and radiographic results when patients with high-energy pilon fractures were treated with either locked or non-locked plates.
Researchers studied 60 patients with 62 high-energy pilon fractures treated between December 2006 and December 2008. Of these patients, 32 were treated with locked plates and 29 were treated with non-locked plates. For approximately 3 months, all patients underwent the same rehabilitation protocol. Researchers observed fractures for approximately 6 months.
At the final follow-up, the Short Musculoskeletal Function Assessment (SMFA), the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale and radiographs were used to assess function. Overall, follow-up findings were available for 33 patients.
Open reduction and internal fixation preceded the external fixator and was observed in four patients with locked plates and in one patient with a non-locked plate. Both groups had similar operative time, tourniquet time and estimated blood loss. Results showed no significant differences between the groups using AOFAS Ankle-Hindfoot Scale and the SMFA.
Complications in both groups included nonunion, malunion, infection, implant failure and painful implants. Loss of reduction was seen in one patient from the locked plate group and three patients from the non-locked group. A secondary procedure was needed for seven patients in the locked plate group and three patients from the non-locked plates group, according to researchers. ‒ by Monica Jaramillo
Disclosures: d’Heurle reports no relevant financial disclosures. Please see the full study for a full list of all other authors’ relevant financial disclosures.