537 Open vs Closed Pilon Fractures: Comparison of Management, Outcomes, and Complications

Abstract Aim Despite the low incidence of pilon fractures, their high impact nature presents difficulties in surgical management/recovery. Current literature is varied, with no universal treatment algorithm. We aim to highlight differences treatment, outcomes, complications between open and closed fractures. Method This retrospective study was conducted at a major trauma centre, including patients over 5-year period. 135 were included (open:48, closed:87). Primary outcome AOFAS score 3-, 6- 12-months post-injury. Secondary outcomes include time partial weight-bear (PWB) full (FWB), bone union time, follow-up time. Post-operative collected. Results Open fractures had lower 3 months post-injury, longer FWB. For both compared ORIF patients, those treated fine wire fixator (FWF) scores 3- 6-months Closed fracture shorter PWB Patients AO/OTA 43A needed FWB than 43C Common (closed:open) superficial infection (22%:54%), post-traumatic arthritis (25%:16%), non-union (11%:24%). Conclusions more extensive soft tissue damage, likely suited for FWF, rather (18% vs 72% ORIF). Due greater associated trauma, frequent complications, delayed definitive fixation, scores. Nevertheless, use staged approach involving temporary external followed or FWF achieved complication rates good functional recovery.