OBJECTIVETo investigate the effects of the ventralateral approach in treating severe Pilon fracture.

METHODSFrom February 2002 to March 2008, 63 patients with Ruedi II-III Pilon fractures were treated with the ventralateral approach, including 36 males and 27 females with an average age of 37 years ranging from 19 to 71 years. The mean time from injury to operation was 8 days (ranged for 2 h-19 d). According to the Ruedi classification system, type II was 32 cases (6 cases of them combined with soft tissue lesion, 4 with open fracture) and type III was 31 cases (9 cases of them combined with soft tissue lesion, 8 with open fracture). The clinical effects were evaluated according to Helfet criteria and the complications were observed including condition of wound healing, infection, bone union, deformity union, motion of the ankle, the degree of the pain and so on.

RESULTSThe first intention achieved in 59 cases, the delayed healing in 4 cases. Stiffness of the ankle was found in 5 cases because of bone disunion. All patients were followed up from 8 to 31 months with an average of 15.3 months. The ranging in bone healing time was from 8 to14 weeks with an average of 10 weeks. According to the Helfet criteria, 28 cases obtained excellent results, 30 good, 5 poor.

CONCLUSIONThe operative treatment of Ruedi I-III Pilon fractures with the ventralateral approach can obtain satisfactory results and avoid complications effectively.