Abordagem terapêutica das fraturas do pilão tibial com Artrodese Primária de tornozelo: relato de caso em um hospital do Triângulo Mineiro

Abstract

Tibial pilon fractures are among the most complex injuries of the lower limb, typically resulting from high-energy mechanisms of trauma and characterized by complex articular comminution and significant soft-tissue compromise. These factors frequently increase the difficulty of anatomical reconstruction and the risk of postoperative complications. This study reports the case of a male patient with a closed left tibial pilon fracture, classified as AO 43C3, Allgöwer 3, initially managed with temporary transarticular external fixation to stabilize the injury and protect soft tissues. After adequate improvement of the soft-tissue envelope, primary ankle arthrodesis was performed using a retrograde tibiotalocalcaneal intramedullary nail. The patient evolved favorably, with no postoperative complications, achieving satisfactory bone consolidation and full functional recovery without pain. This case highlights primary arthrodesis as an effective therapeutic alternative for complex, non-reconstructible tibial pilon fractures, providing stability, reducing complication rates, and preventing the inevitable progression to post-traumatic osteoarthritis in such scenarios.