The adolescent pilon fracture: management and outcome

Area of Science:

• Orthopedic surgery
• Pediatric traumatology
• Skeletal development

Background:

• Pilon fractures in adolescents are complicated by the adjacent physis.
• High-energy trauma is the usual cause, often involving significant soft-tissue injury.
• These fractures have a high complication rate, including physeal arrest.

Purpose of the Study:

• Increase awareness of adolescent pilon fractures.
• Identify complications associated with these injuries.
• Develop an improved treatment plan for better outcomes.

Main Methods:

• Retrospective review of eight pilon fractures in seven pediatric patients (average age 15 years 10 months).
• Treatment involved open reduction and internal fixation for all fractures.
• Fractures were classified using a modified Reudi system, with some requiring a new approach due to associated dislocations.

Main Results:

• Follow-up averaged 16 months.
• Complications included two cases of posttraumatic osteoarthritis and one physeal arrest.
• Sixty-three percent of cases had good to excellent results.

Conclusions:

• Adolescent pilon fractures require specialized management due to physeal involvement.
• A new classification system for pediatric pilon fractures is proposed.
• Open reduction and internal fixation can yield good results, but complications like physeal arrest and osteoarthritis remain concerns.