Work

Management Strategies for Failed Pilon Fractures: A Personalized Approach to Revision Reconstruction

Year: 2025

Type: article

Abstract: Despite advances in staged protocols and fixation techniques, treatment of pilon fractures remains a significant challenge in orthopedic trauma, with up to 21% of patients requiring revision surgery. Management of a pilon fracture that has failed initial treatment involves navigating a myriad of complicating variables, including infection, bone loss, malalignment, and nonunion. Although no single surgical approach can be aptly applied to the broad range of pathology and severity spanned by these patients, this narrative review provides a systematic framework for developing a revision pilon reconstruction plan. We present a protocol for pre-operative assessment and review current techniques for infection eradication, bone defect management, deformity correction, and joint-preserving versus joint-sparing surgery. These fundamental strategies form the foundation of a successful salvage plan and can be personalized to address specific fracture morphology, host factors, and goals of care.

Source: Journal of Personalized Medicine

DOI: 10.3390/jpm15120602

Authors: Lauren Luther, Richard S. Moore III, Sriranjani Darbha, Bethany Gallagher, Daniel J. Stinner

Institutions: Vanderbilt University, Vanderbilt University Medical Center

Language: English

Topic: Bone fractures and treatments

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137