Tibial pilon fractures are complex injuries of soft tissue and bone that challenge patients and surgeons. Outcomes following this injury are guarded, and complications are frequently reported. Soft-tissue compromise at the time of injury is potentially amplified with surgical trauma, necessitating thorough evaluation, preoperative planning, and expertise to minimize complications and maximize outcomes. Understanding angiosome anatomy and typical fracture patterns (and their variations) allows for design of surgical tactics that accomplish these goals.
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Risk Factors for Postoperative Infection in Patients After Pilon Fracture Fixation.
J Foot Ankle Surg
January 2025
The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Orthopedic Department, Rambam Medical Center, Haifa, Israel.
The combination of high energy fractures, extensive soft tissue trauma, and high infection rates in pilon fractures of the distal tibia have long challenged surgeons. Despite the ample evidence, there is no consensus regarding the factors that may influence postoperative infections following surgical management of these fractures. This study aimed to investigate the risk factors for postoperative infections in patients undergoing surgical management for pilon fractures.
View Article and Find Full Text PDFFunctional Outcomes of Pilon Fractures Treated by External Fixation, Delayed Plating, and Open Reduction and Internal Fixation (ORIF): A Prospective Cohort Study.
Cureus
November 2024
Orthopaedics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR.
Objective: This study aimed to evaluate the functional outcomes of three surgical management strategies for pilon fractures, including primary external fixation with delayed plating, external fixation with minimal internal fixation, and single-stage open reduction and internal fixation (ORIF) with plating.
Methods: This prospective cohort study included 34 patients with complex intra-articular fractures of the distal tibia (AO-OTA type 43-C) treated between June 2018 and December 2019. Patients were managed surgically based on the local skin condition and swelling, employing either primary-stage external fixation with delayed plating (Group A), external fixation with minimal internal fixation (Group B), or single-stage ORIF with plating (Group C).
Fibula fixation is not associated with a higher rate of wound complications during pilon fracture open reduction internal fixation.
J Orthop
June 2025
Department of Orthopaedic Surgery, Northwestern University, Chicago, IL, USA.
Introduction: There is a lack of consensus regarding indications for fibula fixation in pilon fractures. Reduction of the fibula fracture can assist with restoring lateral column length and reduction of the tibial plafond during pilon ORIF. However, there are theoretical concerns with wound complications and soft tissue insult.
View Article and Find Full Text PDFIlizarov versus ORIF for Open AO Type-C Pilon Fractures.
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Dr. Nadeem Ahmed, FCPS, Department of Orthopaedics, Surgical Building, Jinnah Postgraduate Medical Centre, Rafiqui Shaheed Road, Karachi, Pakistan.
Objective: This study aimed to evaluate the clinical effectiveness of ORIF versus Ilizarov for the management of Type C closed pilon fractures of the distal tibia at 12 months follow up.
Methods: This retrospective cross sectional study was conducted at Jinnah Postgraduate Medical Center (JPMC) between 29 May 2015 and 27 November 2019 that included patients 18 years and older diagnosed with open AO type C pilon fractures. The primary outcome was the patient-reported Disability Rating Index (DRI) months.
What is the best surgical treatment for the geriatric patient with a severe ankle or pilon fracture - TTC nail or ORIF?
Injury
December 2024
University of Calgary, 0490 McCaig Tower, Foothills Hospital, 3134 Hospital Drive NW Calgary, Alberta, T2N 5A1 Canada. Electronic address:
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