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Related Concept Videos

Fractures: Bone Repair01:27

Fractures: Bone Repair

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Three-Dimensional Reconstruction of Orbital Fractures
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Management Strategies for Failed Pilon Fractures: A Personalized Approach to Revision Reconstruction.

Lauren Luther1, Richard S Moore Iii1, Sriranjani Darbha2

  • 1Department of Orthopedic Surgery, Vanderbilt University Medical Center, 1215 21st Ave. South, Suite 4200, MCE, Nashville, TN 37232, USA.

Journal of Personalized Medicine
|December 24, 2025
PubMed
Summary

Revision surgery for pilon fractures is complex, often involving infection, bone loss, and malalignment. This review offers a systematic framework for planning revision pilon reconstruction, personalizing strategies for optimal outcomes.

Keywords:
bone defect reconstructionfracture related infectionlimb salvagemalunionnonunionpersonalized medicinepilonpost-traumatic arthritisrevision surgerytibiotalar arthritistibiotalar arthrodesistotal ankle arthroplasty

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Area of Science:

  • Orthopedic Trauma Surgery
  • Reconstructive Surgery

Background:

  • Pilon fractures present significant challenges in orthopedic trauma, with high rates of revision surgery.
  • Failed initial treatment of pilon fractures complicates management with issues like infection, bone loss, malalignment, and nonunion.

Purpose of the Study:

  • To provide a systematic framework for developing a revision pilon reconstruction plan.
  • To review current techniques for managing complications in failed pilon fracture treatments.

Main Methods:

  • This narrative review systematically assesses pre-operative assessment protocols.
  • It reviews current techniques for infection eradication, bone defect management, and deformity correction.
  • The review discusses joint-preserving versus joint-sparing surgical approaches.

Main Results:

  • A comprehensive protocol for pre-operative assessment is presented.
  • Effective strategies for managing infection, bone loss, and malalignment are reviewed.
  • Personalized approaches considering fracture morphology, host factors, and goals of care are emphasized.

Conclusions:

  • A systematic framework is essential for successful revision pilon reconstruction.
  • Personalized surgical strategies are crucial for addressing the complexity of failed pilon fracture treatments.
  • This review provides foundational strategies for optimizing salvage plans in challenging cases.