title: A Systematic Review of the Role of Surgical Approaches on the Outcomes of the Tibia Pilon Fracture.
abstract: BACKGROUND
  The role of each surgical approach on the outcomes of pilon fractures has not been investigated in a systematic review.
  
  
  METHODS
  This systematic review was conducted with a thorough literature search on PubMed using the keywords ("pilon" OR "plafond") "fracture." Only articles written in the English language that have been published within the past 15 years and discussed the surgical approach were considered.
  
  
  RESULTS
  A total of 733 patients were included in this review. All the fractures were either OTA Type B or C fractures: 157 were Type B and 576 were Type C. Anterior and medial approaches have some of the best results in the literature with respect to complication rate. The posterolateral and anteromedial approaches have markedly higher complication rates.
  
  
  CONCLUSIONS
  The anterolateral group had the largest number of patients-comprising one third of the entire study population. The anterior approach had one of the lowest complication rates with a patient base that had a high proportion of OTA Type C fractures. The medial approach produced a low complication rate over a larger patient base that had a higher proportion of OTA Type B fractures.
  
  
  METHODS
  Therapeutic, Level IV: Systematic review.
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio jiayong.liu@utoledo.edu.
authors.forename: Jiayong
authors.initials: J
authors.lastname: Liu
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio.
authors.forename: Carson D
authors.initials: CD
authors.lastname: Smith
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio.
authors.forename: Erik
authors.initials: E
authors.lastname: White
authors.affiliation: Department of Orthopaedic Surgery, University of Toledo Medical Center, Toledo, Ohio.
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Ebraheim
mesh_terms: D064386:Ankle Fractures / Q000601:surgery*; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D013978:Tibial Fractures / Q000601:surgery*
keywords: distal tibia; pilon fracture; plafond fracture; surgical approach