Early Tibiotalocalcaneal Arthrodesis Intramedullary Nail for Treatment of a Complex Tibial Pilon Fracture (AO/OTA 43-C)

Foot Ankle Spec. 2015 Jun;8(3):220-5. doi: 10.1177/1938640014548322. Epub 2014 Aug 24.


Management of severely comminuted, complete articular tibial pilon fractures (AO/OTA 43-C) remains a challenge, with few treatment options providing good clinical outcomes. Open reduction and internal fixation of the tibial plafond, tibiotalar arthrodesis, and salvage hindfoot reconstruction procedures are all associated with surgical complications and functional limitations. In this report, we present a case of a complex pilon fracture in a patient with multiple medical comorbidities and socioeconomic disadvantages that was successfully and acutely treated with a retrograde tibiotalocalcaneal hindfoot arthrodesis nail. At final follow-up examination, the patient had decreased pain, a stable plantigrade foot, and could ambulate with normal shoes without any assistive devices.

Levels of evidence: Therapeutic, Level IV: Case series.

Keywords: ankle; arthrodesis; hindfoot; internal fixation; salvage; tibial plafond; tibiotalocalcaneal.

Publication types

  • Case Reports

MeSH terms

  • Ankle Injuries / diagnostic imaging
  • Ankle Injuries / surgery*
  • Arthrodesis / methods*
  • Bone Nails*
  • Calcaneus / diagnostic imaging
  • Calcaneus / surgery*
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Intramedullary / instrumentation*
  • Fractures, Comminuted / diagnostic imaging
  • Fractures, Comminuted / surgery*
  • Humans
  • Middle Aged
  • Prosthesis Design
  • Radiography
  • Tibial Fractures / diagnostic imaging
  • Tibial Fractures / surgery*
  • Time Factors