Individual research recommendation details

Recommendation ID

NG37/03

Question

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)

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

Number

NG37

Date issued

February 2016

Other details