title: Ankle fusion for definitive management of non-reconstructable pilon fractures.
abstract: BACKGROUND
  Highly comminuted pilon fractures, especially with a compromised soft tissue envelope, present a challenging treatment scenario. This study presents our results for patients managed with ankle fusion rather than ORIF.
  
  
  METHODS
  Fourteen patients with ankle joint incongruence after non-reconstructable tibia pilon fractures were treated with primary tibiotalar arthrodesis using a fixed-angle cannulated blade plate. Delayed metaphyseal unions due to bone defects were treated concurrently. The subtalar joint was preserved in all cases.
  
  
  RESULTS
  Metaphyseal healing and stable arthrodesis was obtained in each case. There was one case of blade plate breakage in a patient who still achieved successful arthrodesis without reoperation. Union was achieved at an average of 15 weeks. No secondary procedures were required to obtain union. All 14 patients were ambulatory at last followup. Average followup was 39 weeks.
  
  
  CONCLUSIONS
  Primary ankle arthrodesis can be achieved using a cannulated blade plate to address a non-reconstructable articular surface and metaphyseal bone defects in complex tibia pilon fractures.
authors.affiliation: Los Angeles, CA, USA.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bozic
authors.forename: David B
authors.initials: DB
authors.lastname: Thordarson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Hertz
mesh_terms: D000293:Adolescent; D000328:Adult; D016512:Ankle Injuries / Q000601:surgery*; D001174:Arthrodesis / Q000295:instrumentation* / Q000379:methods; D001860:Bone Plates; D005260:Female; D018460:Fractures, Comminuted / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013978:Tibial Fractures / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult