Acute Shortening and Arthrodesis Technique in Severe Irreparable Tibial Pilon Fracture

Severe soft tissue and bony injuries around the ankle present limb salvage challenges to the orthopedic trauma surgeon. Infection and soft tissue loss often lead to amputation. Reconstruction with external fixation helps prevent deep infection and allows for acute limb shortening as a means of managing the soft tissue loss without free flap coverage. Even significant limb shortening can be remedied with relative ease, utilizing the Ilizarov method of distraction osteogenesis. The following case highlights these principles with the additional use of an integrated fixation technique where a fusion lengthening performed with external fixation is converted during consolidation to internal fixation to decrease time in the frame.