Recommendation ID

Pilon fractures:- In adults with closed pilon fractures, what method of fixation provides the best clinical and cost effectiveness outcomes as assessed by function and incidence of major complications at 2 years (stratified for timing of definitive surgery early [under 36 hours] versus later [over 36 hours])?

Any explanatory notes
(if applicable)

Why this is important:- Pilon fractures involve a significant proportion of the weight-bearing surface of the distal tibia. The damaged joint surface is vulnerable to degeneration. Therefore, the injury can lead to long-term disability, most commonly arthritis with pain and stiffness. Surgery can improve outcomes, allowing reduction and fixation of the fracture and early movement of the ankle joint. However, it has a high incidence of serious complications, particularly related to the vulnerability of the soft tissues around the ankle. The potential for life-changing adverse consequences of both the injury and its treatment is known, but the best management strategy to minimise these consequences is unclear.

Source guidance details

Comes from guidance
Fractures (complex): assessment and management
Date issued
February 2016

Other details

Is this a recommendation for the use of a technology only in the context of research? No  
Is it a recommendation that suggests collection of data or the establishment of a register?   No  
Last Reviewed 29/02/2016