الفهرس 
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Abstract
Tibial Plafond Fractures affect weight-bearing articular surface and comprise < 1% of all lower extremity fractures. Such fractures are due to rotational or axial-loading forces as a result of high-energy trauma.
Plafond means ceiling or dome. The Talus has tibial plafond as a dome or ceiling and articulates with the distal tibia with its smooth surface. Rotational force may produce spiral fractures; it may be extra-articular or intra-articular. Usually, rotational forces produce less soft tissue injuries whereas axial compressive forces produce intra-articular fractures with more soft tissue injuries.
Our study aimed to compare open reduction internal fixation (ORIF) and external fixation by Ilizarov in patients with pilon fracture type C and to clarify which method as a definitive treatment is better in terms of reduction and union results and major complications.
After ethical committee approval, this Systematic review was conducted on Patients aged with 18 years or older with tibial plafond fractures of type C according to the AO/OTA classification including Studies and published papers between January 2000 and January 2022.
This systematic review was conducted on human subjects in different literatures collected from different medical websites between January 2000 and January 2022 in which we involved clinical and/or functional outcomes in ORIF versus Ilizarov fixation for operative treatment of tibial plafond fracture type C according to the AO/OTA classification with follow up period of at least 6 months.
Five Studies literature (Four retrospective and one Prospective) that involved 250 patients, fulfilled the study criteria and were included in this study.
As regards the time till surgery and healing, the current systematic review revealed that there was statistically significant increase in the time till surgery (days) in ORIF group (11.75 ± 2.67) versus EF group (6.95 ± 3.14) (p-value <0.001) and non-significant increase in the time to union (days) in ORIF group (48.10 ± 44.11) than EF group (41.73 ± 37.53) (p-value = 0.287).
The current study results revealed that the Range of Ankle Motion showed a statistically significant increase in the mean dorsiflexion and plantar flexion in ORIF group than EF group (p-value <0.001).
As regards complications, Analysis of the complications (nonunion, malunion, superficial ,deep infections, Osteomyelitis and Arthritis) revealed a statistically significant increase in the percentage of patients with complications in EF group compared to ORIF group (p value <0.001) with significant difference & increase in rates of malunion (p = 0.034) and superficial infection (p=0.012) between EF and ORIF for treatment of TPF. Although the risk of deep infection was higher in the EF group, it was not found to be statistically significant (p = 0.811).
Infections, or other advert events, in theory, were superior in open reduction and internal fixation.
However, our results were against to this concept. As compared to ORIF group, the rate of infection (superficial infection) was higher in the EF group. Fortunately, no evidences showed there were serious infections occurred as well as the compartment syndrome, and no studies reported pulmonary embolism (PE).