Primary Total Ankle Replacement for Acute Comminuted Pilon Fractures in Older Adults: Proposed Indications and a Report of 29 Cases

In this retrospective level IV series with short-term follow-up, primary TAR may be a feasible option for carefully selected older adult patients with comminuted pilon fractures and a preserved metaphyseal cortical shell, demonstrating encouraging early functional outcomes. Longer term follow-up is required to determine implant survivorship and revision risk.