Surgical Approach Options for Pilon Fractures

Pilon fractures are often caused by high-energy axial loads that create complex articular fracture patterns and significant soft tissue damage. This constellation of injuries in an anatomic region with limited soft tissue coverage and tenuous perfusion creates a surgical challenge with the potential for high rates of complications. The goals in surgically treating pilon fractures include achieving an anatomic articular reduction with stable fixation while minimizing disruption to the soft tissue envelope. Even after achieving anatomic reductions, clinical outcomes after surgical treatment of high-energy pilon fractures are often determined by the integrity of the surrounding soft tissue. This demands an intimate knowledge of the surgical anatomy of the lower leg and the approaches available to address these fractures. Here we review various surgical approaches that can be used for reduction and fixation of pilon fractures, including indications and limitations of each approach. Although no surgical approach is suitable for all patients with pilon fractures, an understanding of indications and limitations of several approaches will aid in selection of the most beneficial approach for each injury.
Source: Techniques in Foot and Ankle Surgery - Category: Orthopaedics Tags: Special Focus: Current Concepts in Management of Pilon Fractures Source Type: research