الفهرس 
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Abstract
Fractures of the distal end of the tibial plafond have incidence rate about 1% to 10% of tibial fractures. The aim of this study was to evaluate the early postoperative results and complications of pilon fracture fixation by anatomical antero-lateral plate through antero-lateral approach or combined approaches.
The study included 20 patients with pilon fractures. Among these patients 9 patients below and 11 patients above the age of 35 years old. Five patient had fallen down, three had fallen from height and 12 patients had RTA. ORIF was done within three days for 6 patients and 14 patients had been operated after 3 days. According to level of activity 2 patients had moderate and 18 patients had high level of activity. Regarding type of fracture, 2 patients had type A3, 6 patients had type C1 and 12 patients had type C2 according to AO/OTA classification.
All the 20 patients were treated by ORIF by antero-lateral plate through antero-lateral approach or combined other approaches. A non-weight-bearing below-knee plaster cast was applied to all patients for six to eight weeks. Check X-rays were done postoperatively and during follow up at intervals0, 2, 6, 12 & 26 weeks to assess fracture union and maintenance of reduction.
The duration of follow up was at least 6 months. The final result was assessed clinically and radiologically. Clinical assessment was done using the Olerud and Molander scoring system; the mean score at the end of follow up was 76.50 ± 20.46 ranging from 15.0 – 100.0. The overall results were considered very good in 8 (40.0%) patients, good for 9 (45.0 %) and fair for 2 (10.0%) patients. While one (5.0%) patient was very poor.
There was no significant statistical relationship between the final results and the age, sex, side, level of activity, mode of trauma, type of fracture and time-lapse before operation during the period of follow up. However, there was a significant reduction in the incidence of postoperative pain and metal irritation.
Regarding operative and postoperative complications, one (5.0%) patient non-united and another one (5.0%) had delayed union. Only one (5.0%) patient had superficial wound infection which improved on conservative therapy and one (5.0%) patient complicated by raw area which needed serial sessions of debridement and vacuum seal then improved over daily dressing