THE MANAGEMENT OF THE SOFT-TISSUES IN PILON FRACTURES

Fourteen patients with 15 pilon fractures were reviewed retrospectivel y to analyze cases treated by open reduction and internal fixation thr ough both anteromedial and lateral incisions. The protocol for this pr ocedure involved objective soft-tissue evaluation, anteromedial wound closure, judicious use of primary skin grafting, and delayed primary o r secondary closure for the lateral wound. Eleven fractures were treat ed according to the established principles of the Association for the Study on Internal Fixation (AO/ASIF). The type and incidence of wound complications were recorded. Most injuries reviewed were of the high-e nergy or Type III fracture as defined by Reudi and Allgower. There was only one patient with a wound complication. This technique minimized the potential for wound complication and disastrous disability.