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Acta Ortop Mex. 2013 Nov-Dec;27(6):363-6.

[Results of the treatment of high energy tibial pylon fractures].

[Article in Spanish]



Several treatment are available for these injuries. In developed countries they are currently treated with minimally invasive plates. This paper describes the results obtained using external fixators in patients with tibial pylon fractures.


A retrospective, cross-sectional study was conducted from 1999 to 2009 at Querétaro General Hospital. A total of 39 patients were operated on; 18 met the inclusion criteria; follow-up ranged from 1 to 9 years.


Of the 18 patients enrolled, 22% were females and 78% males. The most frequent fracture was 43 A2 of the AO classification accounting for 67%. Mean age was 41.2 years +/- 9.3, mean healing time was 14.9 weeks +/- 7.26, with p = 0.005; mean follow-up was 4.1 +/- 4.9 years. Twenty-two percent were Gustilo type II open fractures; 78.2% required open reduction plus an external fixator; 22.8% underwent closed reduction plus external fixator; the mean score in the SF-36 scale was 78.05 +/- 14.76. Only one patient required another surgery; 94.4% returned to their usual daily activities. Among the latter, 77.7% had normal gait, 22.2% had full range of motion, 72.2% had a pain score of four in the VAS and 27.7% were pain free.


The use of external fixators for the definitive management of these fractures is effective, as it helps avoid additional surgeries (up to 35%) and has a shorter healing time.

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