Hybrid external fixation of tibial pilon fractures.

Although external fixation reduces drastically the number of iatrogenic complications compared with acute open reduction and plate fixation, the prognosis for functional recovery after a pilon fracture remains guarded. Many authors have applied validated patient outcome measures to patients who have had pilon fractures. These studies confirmed that there are significant decreases in general health perceptions, physical and emotional role function, pain, and energy levels in patients who have suffered pilon fractures, regardless of the treatment modality. The high-energy tibial pilon fracture with soft tissue compromise remains a treatment dilemma. Hybrid external fixation with limited open reduction has proved to be a safe, reproducible, and effective treatment modality for this complex fracture.