This 2011 JAAOS review by Crist et al. synthesizes current surgical management strategies for pilon fractures — complex intra-articular distal tibial injuries — focusing on how surgical timing, approach selection, plating techniques, and soft-tissue management influence complications and outcomes.
When you see a high-energy pilon fracture with soft-tissue swelling, fracture blisters, or ecchymosis over the planned incision, temporize with ankle-spanning external fixation and wait for the wrinkle test before committing to definitive ORIF — rushing to the OR is the historical source of catastrophic wound complications.
Counsel patients that socioeconomic and comorbidity factors (diabetes, tobacco, low income) predict their functional recovery as much as your reduction quality does.
This 2011 JAAOS review by Crist et al. synthesizes current surgical management strategies for pilon fractures — complex intra-articular distal tibial injuries — focusing on how surgical timing, approach selection, plating techniques, and soft-tissue management influence complications and outcomes.
When you see a high-energy pilon fracture with soft-tissue swelling, fracture blisters, or ecchymosis over the planned incision, temporize with ankle-spanning external fixation and wait for the wrinkle test before committing to definitive ORIF — rushing to the OR is the historical source of catastrophic wound complications.
Counsel patients that socioeconomic and comorbidity factors (diabetes, tobacco, low income) predict their functional recovery as much as your reduction quality does.