Nicholas Strasser MD Sports Foot and Ankle Surgeon

Pilon Fractures - preventing soft tissue related complications


Indications weekly follow up!

Thank you to all who joined us for our webinar last week where we covered Pilon (Pea-lon) fractures.  We hit so many key points.  In case you missed the webinar, click here to access the recordings!

Remember the 4 tenants.

1) Anatomic reduction and fixation of associated fibular fracture

2) Anatomic restoration of the articular surface

3) Bone grafting of metaphyseal defects including use of allograft, autograft and bone graft substitutes.

4) Fragment specific fixation plating to allow early motion. (ie. mini frag plating)


These injuries are more than just bone.  These are high energy injuries with a tenuous soft tissue envelope.  Minimizing complications include careful handling of the soft tissue.  As Jan Szatkowski said, “The issue is the tissue”

Keys for Infection Prevention Include….

1) Thorough and meticulous irrigation and debridement (1)

2) Close traumatic wounds early if possible

3) Early administration of IV antibiotics. Consider use of intramedullary synthetic bone graft with antibiotics – Calcium sulfate or phosphate(2)

4) Tension Free Early Closure if possible

5) Judicious use of negative pressure wound dressings

6) Provisional External Fixation for stability and soft tissue rest