Orthopaedic Trauma Pilon Fractures

Pilon fractures are not hard to describe but can be very difficult to treat, often involving a lengthy, sometimes painful, recovery time. The early important factors to note are the degree of articular involvement; the amount of comminution; and the amount and manner of soft tissue involvement. These factors will determine the surgeon's decision making and type of treatment. Operative care involves protecting the skin, while reducing the fracture and aligning the joint surface. Surgery is more likely to involve external fixation with postponement of internal fixation for 1-3 weeks. Postoperative care should be vigilant and comprehensive to ensure that patients do not develop any adverse outcomes. Education regarding home care should be complete and easy to understand so that there are no misunderstandings that might delay treatment if complications should arise. Early motion and physical therapy should be initiated to prevent postoperative stiffness. Patients should be educated from the beginning that these fractures can be difficult to treat and the final outcomes may not always be optimal. With careful preoperative planning and excellent care, these patients may return to a good quality of life. Copyright © 2011 National Association of Orthopaedic Nurses. Unauthorized reproduction of this article is prohibited.