High-Energy Pilon Fractures: Role of External Fixation in Acute and Definitive Treatment. What are the Indications and Technique for Primary Ankle Arthrodesis?

Foot Ankle Clin. 2020 Dec;25(4):523-536. doi: 10.1016/j.fcl.2020.08.005. Epub 2020 Oct 3.


External fixation is an essential tool in the management of high-energy pilon fractures. Reduction techniques using the external fixator and fixation constructs for use with external fixation as a part of stage management are reviewed. The concepts of external fixation with limited articular fixation is discussed. The use of circular external fixation in both acute management of high-energy pilon fractures, as well as the indications and technique for acute ankle arthrodesis as part of primary treatment of pilon fractures are outlined.

Keywords: Ankle; Arthrodesis; External fixation; Pilon fracture; Plafond.

Publication types

  • Review

MeSH terms

  • Ankle
  • Ankle Fractures*
  • Ankle Injuries*
  • Arthrodesis
  • External Fixators
  • Fracture Fixation
  • Fracture Fixation, Internal
  • Humans
  • Retrospective Studies
  • Tibial Fractures* / diagnostic imaging
  • Tibial Fractures* / surgery
  • Treatment Outcome