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The Posterior Approaches to the Posterior Pilon Fracture

Greisberg, Justin, MD; Sonnenfeld, Julian J., MD

Techniques in Foot & Ankle Surgery: December 2018 - Volume 17 - Issue 4 - p 179–184
doi: 10.1097/BTF.0000000000000183
Special Focus: Advances in Ankle Fracture Management

Between simple malleolar fractures and more complex pilon injuries, is the posterior pilon fracture. Involving a variable amount of posterior tibial articular surface, these injuries may benefit from a posterior approach to reduce and stabilize the fragments. The posterolateral approach can be considered the “workhorse,” and allows good access to the tibia and fibula. The posteromedial approach may be helpful for more complex patterns, but is closer to the tibial neurovascular bundle. These approaches can be performed safely, with low complication rates and generally favorable outcomes.

Level of Evidence: Diagnostic Level 4. See instructions for authors for a complete description of levels of evidence.

Department of Orthopaedic Surgery, New York Presbyterian/Columbia University, New York, NY

The authors declare no conflict of interest.

Address correspondence and reprint requests to Justin Greisberg, MD, Department of Orthopaedic Surgery, New York Presbyterian/Columbia University, 622 W 168th St., PH 11, New York, NY 10032. E-mail:

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