Comparison of results of conservative method and plate fixation method for the treatment of Ruedi/allgower type 1 Pilon fractures

The aim of this study was to compare the results of cast application and plate fixation in the management of Ruedi/Allgower type I Pilon fracturesPatients and methods: Forty-two patients (24 females, 18 males) with Ruedi/Allgower type I Pilon fractures were retrospectively reviewed. Sixteen patients (Group 1) (10 females, 6 males; mean age 43 years; range 18-56) had been treated with cast application and 26 patients (Group 2) (14 females, 12 males; mean age 37.7 years; range 19-52) had been treated with plate fixation. All patients were diagnosed with X-ray. Radiologic examinations were made using Ovadia and Beal’s criteria. Long term functional results of foot and ankle were evaluated according to the Tenny and Wiss citeria. The mean follow-up period was 28 months (range 12-44) in Group 1 and 31 months (range 16-46) in Group 2.Results: Mean reduction quality score was 12 points in Group 1, and 10 points in Group 2. The difference between the groups was statistically significant (p<0.05). Mean long term functional results of foot and ankle scored 84 and 86 in Group 1, and Group 2, respectively (p>0.05). Time to union was not different between both groups (p>0.05).Conclusion: Although the quality of reduction obtained with cast application was not as satisfactory as plate fixation; good results could be obtained in both groups regarding long term functions

The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures

The aim of this study was to determine the effect of fracture type and angular deterioration on the outcome of calcaneal fractures.Materials and methods: Thirty-two patients (23 males, 9 females; mean age 45 years) with calcaneus fractures retrospectively reviewed. Twenty-four fractures were closed, and eight fractures were open. Böhler and Gissane angles were measured using patient’s before, and after reduction X-ray films. According to the Essex-Lopresti classification there were three type I, 14 type II, and 15 type III fractures. Five patients were treated with casting (Group I), 19 patients with closed reduction K-wire application (Group II), and 8 patients with plate fixation. Final clinical outcome were assessed by Maryland Foot Score. Mean follow-up period was 109 weeks.Results: Mean Böhler and Gissane angles were 7°, 85° before reduction, and 20°, 100° after reduction, respectively. The mean Maryland Foot Score was 62 (range 55-72) in Group I, 68 (range 40-90), and 66 (range 58-79) in group II.The Maryland Foot score in Type I fracture was higher than Type III (p=0.025), and Typ II (p=0.094), respectively. In terms of last radiologic examination, the Maryland Foot Score was higher in those angle’s were in normal border than whose angle’s were abnormal (p=0.027 and p=0.02, respectively). Mean correction of angles in Group III were more than Group I, and Gruop II (p<0.05).Conclusion: Severe calcaneus fracture was related to poor functional outcome. Böhler and Gissane angle can be more corrected with plate fixation method, but has similar functional outcome