High-energy pilon fractures management

Pilon fractures are distal tibia end fractures affecting the weight-bearing articular surface. They represent around 1% of all lower extremity fractures, and are more common in males between 35 and 40 years of age.1 Such injuries may be caused by highor low-energy mechanisms. Axial compression injuries where the talus impacts on the distal articular surface, causing implosion of the tibial plafond are caused by high-energy mechanisms with key characterisitcs including severe soft-tissue injuries, comminution and multiple displaced articular fragments. Conversely, rotational injuries are typically low-energy fractures with less soft-tissue injury and, usually, a distal tibial spiral fracture pattern. In this review, we will focus on the management of high-energy, axial compression injuries.