Pilon fractures

Purpose of review: Pilon fractures are a challenging area of orthopedic trauma. As the number of clinical and basic science studies of these complex fractures increases, it is imperative that orthopedic surgeons remain current in their understanding of these potentially disabling fractures. Recent findings: Recent literature on this topic focuses on various surgical approaches to the distal tibia. This attempt to improve the outcomes of surgical techniques arises from previous literature that focused on soft tissue management. In response to this understanding of the importance of the soft tissues, many trauma centers have incorporated the use of delayed surgery and minimally invasive techniques in an effort to improve complication rates and overall patient outcomes. Summary: Recent published findings give insight into various treatment strategies for pilon fractures. Numerous works describe technical approaches that have shown some success with certain types of pilon fractures. In certain cases, multiple treatment options can be used to gain the best outcome from this devastating injury. Pilon fractures remain difficult to treat, even by the most welltrained orthopedic surgeon. Future research with comprehensive prospective studies is still needed to further our understanding of this complicated fracture.