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Volume 14
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10.3390/jcm14020358
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Article

The Impact of Fibular Fixation Method on Pilon Fracture Healing

by
Anthony Perugini
1,*,
Scott Hyland
1,
James Iandoli
1,
Zachary Hill
2,
John Peabody
1,
Daniel DeGenova
1,
Mallory Faherty
3 and
Benjamin Taylor
2
1
OhioHealth, Department of Orthopedics, Columbus, OH 43228, USA
2
OhioHealth Orthopedic Trauma and Reconstructive Surgeons, Grant Medical Center, Columbus, OH 43215, USA
3
OhioHealth Research Institute, Riverside Methodist Hospital, Columbus, OH 43214, USA
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2025, 14(2), 358; https://doi.org/10.3390/jcm14020358
Submission received: 9 December 2024 / Revised: 6 January 2025 / Accepted: 7 January 2025 / Published: 9 January 2025
(This article belongs to the Special Issue Clinical Perspectives on Foot and Ankle Surgery)
Versions Notes

Abstract

Background: Pilon fractures are associated with high-energy injuries, and there is presently much debate as to optimal fixation strategies and timing of intervention. There is little evidence comparing the type of fibular fixation during pilon fracture fixation. The purpose of this study was to compare fibular fixation methods in complex pilon injuries as it relates to pilon union rates and development of post-traumatic arthritis. Methods: This was a retrospective review from an urban Level 1 trauma center from January 2009 to May 2019, including patients age ≥ 18 who sustained a pilon fracture with an associated fibula fracture. Patients were allocated into one of three groups based on fibular fracture treated with plating, intramedullary device, or no fixation. Radiographic analysis was performed postoperatively and at final follow up to evaluate for tibial or fibular nonunion, malunion, talocrural angle, and ankle Kellgren–Lawrence grade. Results: Of the 107 patients in this study, 42 underwent surgical fixation of their fibular fracture. There were no differences with respect to tibial or fibular union rates amongst the three groups. Furthermore, there were no differences in the presence of radiographic ankle arthritis at final follow up. However, Kellgren–Lawrence arthritis grading did appear to be a more severe grade in patients who did not undergo fibular fixation (p = 0.001). Conclusions: Fibular intramedullary fixation does not appear to influence tibial or fibular nonunion rates as compared to plating in complex pilon injuries.
Keywords: pilon; ankle trauma; fibular fixation; post-traumatic arthritis pilon; ankle trauma; fibular fixation; post-traumatic arthritis

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MDPI and ACS Style

Perugini, A.; Hyland, S.; Iandoli, J.; Hill, Z.; Peabody, J.; DeGenova, D.; Faherty, M.; Taylor, B. The Impact of Fibular Fixation Method on Pilon Fracture Healing. J. Clin. Med. 2025, 14, 358. https://doi.org/10.3390/jcm14020358

AMA Style

Perugini A, Hyland S, Iandoli J, Hill Z, Peabody J, DeGenova D, Faherty M, Taylor B. The Impact of Fibular Fixation Method on Pilon Fracture Healing. Journal of Clinical Medicine. 2025; 14(2):358. https://doi.org/10.3390/jcm14020358

Chicago/Turabian Style

Perugini, Anthony, Scott Hyland, James Iandoli, Zachary Hill, John Peabody, Daniel DeGenova, Mallory Faherty, and Benjamin Taylor. 2025. "The Impact of Fibular Fixation Method on Pilon Fracture Healing" Journal of Clinical Medicine 14, no. 2: 358. https://doi.org/10.3390/jcm14020358

APA Style

Perugini, A., Hyland, S., Iandoli, J., Hill, Z., Peabody, J., DeGenova, D., Faherty, M., & Taylor, B. (2025). The Impact of Fibular Fixation Method on Pilon Fracture Healing. Journal of Clinical Medicine, 14(2), 358. https://doi.org/10.3390/jcm14020358

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