Management of a Pilon Fracture Complicated by a Bent Plate in Situ with Nonoperative Correction

Case: Hardware complications in the perioperative period of a pilon fracture open reduction internal fixation or fusion procedure present a unique challenge. Revision of hardware can lead to additional complications. In this case report, we share a technique of in situ plate bending to manage damaged hardware in a patient who underwent a primary tibiotalar arthrodesis for a pilon fracture. Conclusion: Preoperative planning, protection of the soft tissue envelope, and use of the “F” tool are keys to the success of this treatment method. Proper technique allows for a noninvasive method for correcting hardware failure and avoiding further complications.