New Principles in Pilon Fracture Management

The tibial pilon fracture is a complex lesion, which requires experienced clinical judgment and adequate planning to achieve good results. Treatment concepts enunciated by Rüedi and Allgöwer remain valid but have undergone modifications. The reconstitution of the fibular length is not always the first step to be performed. In the reconstruction of the articular surface, the prognosis is already sealed by the initial cartilage damage, and it is better to achieve stability and alignment. The stabilization of the medial column is essential, but it must be associated with the stabilization of at least one other column in complex fractures.