Management of Tibia Pilon Fractures With Ring External Fixation

Tibia pilon fractures are complex injuries associated with ankle articular cartilage damage and soft tissue compromise. Modern circular external fixation methods are useful in their surgical management, especially for open fractures, severe soft tissue injury, fracture patterns with bone loss or compromise, severe cartilage loss, and certain patient factors. Surgical techniques involve ring block concepts, strategic distal tibia wire placements, hexapod fixators with software-guided bone alignment, and other uses of circular external fixation including ankle joint distraction, augmentation of internal fixation to create integrated constructs, intentional limb deformation for soft tissue defects, bone transport, and primary arthrodesis. Circular external fixation has comparable and sometimes favorable outcomes versus all internal fixation techniques and can be the treatment of choice for certain complex pilon cases.