Revision Surgery for Pilon Fractures

Pilon fractures are complicated injuries that have a significant impact on patients. They involve direct injury to the articular surface of the ankle joint. However, the severity of the injury is most commonly seen to the soft tissues surrounding the ankle. For these reasons, it is not uncommon to have significant postsurgical complications that require revision surgery. Complications such as infection, nonunion, malunion, and post-traumatic arthritis are common, and they have been well documented in the literature. Revision surgeries are complicated and require a significant amount of planning. Proper preoperative evaluation of infection is important, and it is important to obtain necessary imaging studies. Careful consideration should be paid to residual deformities in the sagittal and coronal planes. Removal of indwelling hardware must be accounted for, and the need for revision hardware should be well thought out. Dealing with deformity and post-traumatic arthritis is paramount in dealing with revision pilon surgery.