Full Weight Bearing Following Pilon Fracture – Feasible With Hinged External Fixation Frame

Pilon fractures represent one of the most complex injures to treat for orthopedic surgeons. Anatomical reduction is challenging, and the "personality" of this type of fracture makes it difficult to standardize the treatment. There have been proposed several treatments such as temporary external fixation followed by ORIF or combination of internal and external fixation. At this point there is no a "gold standard".

The Ilizarov external fixator has been shown as a good alternative for patient with comminuted fractures. However, none of the existing treatment protocols allows combination of range of motion with immediate full weight bearing. We present a case of a 22 year old soldier sustaining a shrapnel injury resulted in a comminuted though congruent pilon fracture. He was treated with hinged Ilizarov ankle distraction frame combined with limited internal fixation. Immediate weight bearing and range of motion exercises were initialized. Good results where demonstrated at the end 18 months of follow-up period.