LONG-TERM OUTCOMES AND COMPLICATIONS OF CT-GUIDED STAGED SURGICAL TREATMENT FOR PILON FRACTURES IN ATHLETES

Abstract

Objective: To assess the outcomes, complications, and long-term follow-up results of CT-guided staged surgical treatment for pilon fractures in athletes. Methods: This retrospective study analyzed 60 athletes who underwent surgery for old pilon fractures from January 2021 to December 2021. Patients were categorized into five types (I-V) based on the size and location of Die-punch bone masses observed in CT cross-sections. We compared preoperative and post-internal fixation removal outcomes using the Olerud-Molander ankle function scale and the pain visual analogue scale (VAS). Results: Significant improvements in the Olerud-Molander scores from preoperative to final follow-up were observed across all types (Type I: 26.34 to 62.12; Type II: 25.45 to 63.23; Type III: 26.45 to 62.34; Type IV: 25.78 to 63.33; Type V: 25.89 to 62.41; all P < 0.05). VAS scores also improved significantly (Type I: 3.57 to 1.52; Type II: 3.52 to 1.53; Type III: 3.55 to 1.55; Type IV: 3.51 to 1.45; Type V: 3.55 to 1.48; all P < 0.05). The excellent treatment rate varied across types but showed no statistical difference. Postoperative complications were managed symptomatically, with rates of 14.29% to 50.00% across types, showing no significant differences. Conclusion: CT-guided staging for surgical treatment of pilon fractures in athletes enables precise management of surgical approaches, demonstrating substantial improvements in clinical outcomes with manageable complications. This method is feasible and effective, suggesting a strong basis for its application in managing athletic injuries related to pilon fractures.