Staged treatment of pilon fractures

Aim: To evaluate outcomes following staged anterolateral plating of pilon fractures. Methods: Over a 5 year period, patients with pilon fractures received four treatment regimens (staged anterolateral plating, staged medial plating, definitive external fixation, early total care). We defined five outcomes (reduction, soft tissue complications, infection, non-union, malunion) and assessed the outcome of fractures treated by these interventions. Results: Staged anterolateral plating or staged medial plating achieved comparable reduction and soft tissue complications. Staged medial plating had higher infection rates, malunion and non-union rates. Conclusions: Staged anterolateral plating is superior to staged medial plating in the management of pilon fractures.