Foot Loading Analysis of Intra-articular Tibia Pilon Fracture.

ABSTRACT

BACKGROUND: Although pilon fractures are rare, they are important for orthopedic surgeons because of the difficulty of their treatment and their adverse effects on gait function. The aim of this was study to evaluate the relationship between the reduction quality of the fracture, functional results, ankle arthrosis, and plantar pressure distribution in patients with tibia pilon fractures. METHODS: In this study, a total of 62 patients treated for an intraarticular pilon fracture in our clinic between January of 2015 and January of 2019 were evaluated retrospectively. Postoperative reduction qualities of the patients were evaluated with the Ovadia-Beals criteria; ankle functional scores were evaluated with the Teeny-Wiss score; and ankle arthrosis was evaluated with the Takakura classification. At the last patient follow-up, foot loading analysis was performed, and the results were evaluated for their relation with postoperative reduction quality, ankle function, and ankle arthrosis. RESULTS: There were 62 patients (50 men and 12 women). The average age was 43.3 years (range, 19-78 years). The mean follow-up was 34.3 months (range, 24-58 months). The mean Ovadia-Beals score was 12.35 ± 4.6 on the postoperative plain radiographs of the patients; the mean Teeny-Wiss score at the last follow-up was 76.82 ± 17.69; and the mean Takakura score was 1.47 ± 1.35. Based on the pedobarographic measurements, 47.58% of the patients put weight on the anterior portion and 52.42% on the posterior portion of the foot in the anteroposterior plane. In the mediolateral plane, 42.15% loaded on the medial portion of the ankle and 57.85% loaded on the lateral portion of the foot. CONCLUSIONS: Intra-articular tibia pilon fractures can be demonstrated by lateralization of the walking axis and changes in gait patterns and can be associated with clinical outcome.