Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents.

Because of this, they may be difficult to fixate and are historically associated with high rates of complications and poor outcome.

[1] Pilon fractures are categorized by two main X-ray schemes, Ruedi-Allgower classification system.

Treatment strategies and fixation methods used include internal and external fixation, as well as staged approaches, with the aim of reducing the fracture, reconstructing the involved bones and restoration of articular surface congruence, with minimal insult to soft tissues.

[7] Vacuum-assisted wound closure therapy and using a staged protocol (awaiting soft-tissue recovery before extensive reconstructive efforts) may play a positive role.