Management of severely comminuted, complete articular
tibial pilon fractures (Rüedi and Allgöwer type III) remains
a challenge, with few treatment options providing good
clinical outcomes. Twenty patients with severely comminuted
tibial pilon fractures underwent primary ankle arthrodesis with
a retrograde calcaneal nail and autogenous fibular bone graft.
The fusion rate was 100% and the varus malunion rate was
10%. Fracture union occurred at a mean of 16 weeks (range,
13-18 weeks) postoperatively. Primary ankle arthrodesis is a
successful method for treating highly comminuted tibial pilon
fractures, having a low complication rate and a high satisfaction
score.