Incidence and Management Implications of Talus Osteochondral Lesions in Tibial Plafond (Pilon) Fractures Identified Via Nano-Arthroscopy at Time of External Fixation: A Pilot Study

Previous studies have demonstrated a high incidence of talus osteochondral lesions (OCLs) associated with rotational ankle fractures, with rates reported as high as 45%. Consequently, an increasing number of surgeons have employed ankle arthroscopy at the time of fixation to evaluate and manage potential OCLs.

To date, no studies have assessed the incidence of talus OCLs associated with high-energy tibial plafond (pilon) fractures. Ankle arthroscopy at the time of definitive fixation for pilon fractures is often contraindicated due to significant soft tissue swelling and the risk of wound complications. However, if concurrent OCLs could be identified at the time of temporizing external fixation using nano-arthroscopy, such findings could inform surgical planning, including modifications to approach, staging, or definitive management.

Patients will be identified through a treating relationship to the patient when they present for management of their injury. Written consent for the arthroscopy portion, photos, sample collection will be performed while they are in the hospital before surgery, or at the same time they are consented for surgery.

The goal of the study is to enroll 25 participants.

Study Procedures