Publication:

Functional outcome of JESS fixation and bone grafting in distal tibial plafond-pilon fracture: a prospective study

Background The Pilon fractures are one of the most difficult to treat. Fracture known as “orthopedicians nightmare”. The incidence of complications following ORIF of pilon ranges from 10-55% and other complication are infection, loss of reduction, secondary arthrosis. In these circumstances JESS and Bone grafting is cost effective and less hospitalization. Our aim was to evaluate in the functional outcome of JESS fixation and bone grafting in distal tibial plafond- pilon fracture using Olerud and Molander score.

Methods The JESS fixation and bone grafting was used for pilon fracture in 30 patients, 24 male and 6 female. Mean age 44 years range (18-60 years). Fractures caused by fall and RTA. All were treated with JESS fixation and bone grafting. the patients were assessed clinically and radiographically at regular interval of 1 month and later 2 months interval. Outcome was assessed using Olerud and Molander score. Complications were recorded.

Results 12 patients had Ruedi and Allgower type II fracture and 18 patients had type III fracture. After 9 month of follow up midterm OMAS score- 11.766 was achieved. Outcomes were good in 71.25% and fair results in 50.83% respectively. The complication seen was residual ankle pain in 6.66% patients and implant failure in 13.33%.

Conclusions Fixation of pilon fracture with JESS and bone grafting is associated with good functional outcome in type II and fair in type III pilon fracture. The incidence of complications high in type III pilon fracture.