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Abstract Objective To compare the clinical effect of variable angle locking compression plate (VA-LCP) and a common locking compression plate (LCP) in the treatment of Rüedi Ⅲ Pilon fractures.Methods A retrospective analysis was conducted of the clinical data of 48 patients with Rüedi-Ⅲ Pilon fractures treated at the People's Hospital of Danyang from January 2018 to December 2020.Of these，17 patients received VA-LCP-based internal fixation (study group)，consisting of 11 males and 6 females，aged between 31 and 62 years old，with a mean age of (46.3±6.7)years old.Additionally，31 patients underwent traditional LCP-based internal fixation (control group)，including 22 males and 9 females，aged from 36 to 67 years old，with a mean age of (48.7±7.6)years old.Data on operation time，hospital stay，incision healing，fracture healing，and complications were collected during follow-up.Postoperative X-rays were used to determine the Burwell-Charnley radiological score，and the American orthopaedic foot and ankle society(AOFAS) ankle-hindfoot score was employed to assess ankle joint function at the final follow-up.Results All patients were followed up for 12 to 18 months，with an average follow-up time of (15.2±4.4)months.There were no significant differences between the two groups in terms of age，gender，fracture side，preoperative waiting time，operation time，and fracture healing time，as well as postoperative radiological evaluation of Burwell-Charnley fracture reduction (P＞0.05).In the study group，the AOFAS score at the last follow-up ranged from 70 to 95，average (85.4±11.3)，with 11 excellent cases，4 good cases，2 fair cases，resulting in an excellent and good rate of 88.2%.Ankle plantar flexion was 36 ° to 51 °，average (40.3±7.5)°，and dorsiflexion was 16 ° to 25 °，average (20.7±3.6)°.In the control group，the AOFAS score ranged from 56 to 94，average (81.2±14.6)，with 18 excellent cases，8 good cases，5 fair cases，resulting in an excellent and good rate of 83.9%.Ankle plantar flexion was 32 ° to 50 °，average (37.4±8.5)°，and dorsiflexionwas 13 ° to 22 °，average (18.1±3.6)°.There was no significant difference in ankle function between the two groups.The incidence of soft tissue complications in the study group was better than that in the control group，and the difference was statistically significant (P＜0.05).In the study group，there was 1 case of grade B healing of the incision.In the control group，there were 1 case of incision infection，5 cases of grade B healing，1 case of nerve irritation，and 4 cases of tendon irritation.Conclusion Both VA-LCP and LCP can achieve good clinical efficacy in the fixation of Rüedi-Ⅲ pilon fractures，and be selected on the condition of the fracture.
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Corresponding Authors:
Zhou Lijian
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