Die Defektpseudarthrose des Pilon tibiale: Möglichkeiten der Defektrekonstruktion und Endoprothetik

The operative treatment of tibial pilon fracture is a surgical challenge, especially the treatment of its complications. Among them, a non-union with bone loss at the ankle joint is a major complication and high surgical expertise is needed due to its complexity. Besides the option of a fusion, nowadays the option of a total ankle replacement (TAR) is also available. The meticulous analysis of the reasons that lead to the non-union and bone defect, the identification of the individual demands of each patient, as well as the biological and biomechanical characteristics of the micro-environment of the bone are prerequisites for the planning of a personalized treatment of the severe complication. The present paper focuses on the reasons that can lead to a non-union with defect after surgical treatment of tibial pilon fractures, as well as on the available treatment options in the form of either an ankle fusion or TAR.