title: Decisions and staging leading to definitive open management of pilon fractures:  where have we come from and where are we now?
abstract: Historically, the treatment and outcomes related to pilon fractures have been variable despite anatomical reduction and fixation. However, with the advent of newer implant technologies, improved surgical techniques, and the management via a staged protocol, results have indicated encouraging clinical outcomes with minimization of postoperative complications. This review focuses and outlines the current strategies, decision-making processes, and definitive treatment options regarding the notoriously difficult to treat pilon fracture.
  
  
  METHODS
  Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: Division of Orthopaedic Trauma, Department of Orthopaedic Surgery, UMDNJ-New Jersey Medical School, Newark, NJ 07103, USA. liporace33@gmail.com
authors.forename: Frank A
authors.initials: FA
authors.lastname: Liporace
authors.forename: Richard S
authors.initials: RS
authors.lastname: Yoon
mesh_terms: D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D005597:Fractures, Open / Q000601:surgery*; D006801:Humans; D013978:Tibial Fractures / Q000601:surgery*