Salvage of the infected pilon fracture

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Abstract
Salvage of an infected fracture of the distal tibia—whether initially open or closed—requires a strategy individualized to the presenting problem. If hardware is present, it may be left in place if it securely stabilizes a fracture site associated with viable bone. Most cases, however, require removal of hardware, debridement of dead bone, and application of external fixation for control of sepsis. Autogenous bone grafting is usually needed to reconstruct any residual osseous defect. The authors observed several cases in which an unsuspected, chronic ankle-joint infection caused persistent sepsis. The infection seems to track into the ankle through open fracture lines after wound breakdown. In such situations, the chronic ankle joint infection must be eradicated (by arthrodesis) to control sepsis.

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