Tibial pilon fractures: a review of incidence, diagnosis, treatment, and complications

Abstract

Tibial pilon fractures are challenging to treat, as they are typically intra-articular and associated with extensive soft tissue damage. We briefly review the anatomy of the distal tibia, as well as the pathophysiology of pilon fractures. The treatment of tibial pilon fractures is still controversial in the literature, and we present some of the available options. Consideration is also given to peri-operative complications, such as preoperative oedema and blistering and late postoperative traumatic arthritis. Finally, we propose a treatment algorithm (used in our institution), taking into account the level of associated soft tissue injuries. The use of a 2-phase treatment protocol is recommended; however, to date, no absolute treatment protocol exists for these injuries.