[Hot topics and challenges in the treatment of Pilon fractures]

Pilon fractures are comminuted fractures of the distal tibial articular surface caused by high-energy axial loading, typically resulting from falls from height, motor vehicle accidents, or sports injuries. The patients with Pilon fractures are often associated with articular cartilage damage, metaphyseal comminution, and severe soft tissue injury, which can lead to poor long-term prognosis. Pilon fractures are among the most challenging types of fractures to treat. At present, there are still some controversies regarding the treatment of Pilon fractures. This article aims to explore hot-topic issues in the treatment of Pilon fractures, including early and staged treatment strategies, management of fibular fractures, selection of surgical approaches, reduction techniques, and choice of internal fixation devices, and summarize the updates in treatment concepts, aiming to provide reference for the clinical diagnosis and treatment of Pilon fractures.