Fractures of the tibial plafond. Evolving treatment concepts for the pilon fracture.

Pilon fractures represent a most difficult challenge to the orthopedist. Assessment of the degree of energy causing the fracture and careful planning of the joint reconstruction will lead to acceptable results in most cases. High-energy pilon fractures should be treated with great care and respect because the risk of complications is high and the likelihood of a good functional ankle is less predictable. Detailed and individualized postoperative care coupled with a knowledge of salvage procedures, should complications develop, are needed to treat the full spectrum of pilon injuries.