Objective:

To evaluate the clinical efficacy of treating talar body and tibial pilon fractures using a modified lateral malleolar osteotomy approach.

Approach:

• Patient cohort: Five patients with combined talar body and tibial pilon fractures were included, classified according to Sneppen and Rüedi-Allgöwer systems.
• Surgical technique: A modified lateral malleolar osteotomy was performed to achieve exposure, reduction, and fixation of the fractures.
• Outcome assessment: Clinical outcomes were measured using the Hawkins sign, AOFAS score, VAS pain score, and ankle range of motion.

Key Findings:

• Allpatientsdemonstratedunionattheosteotomysitebythreemonthspostoperatively.Thecohortincludedfivepatients,withthreetypeIandtwotypeIItalarbodyfractures,andallpilonfracturesclassifiedastypeIIaccordingtotheRüedi-Allgöwersystem.MeantimetopositiveHawkinssignwas13.2±1.8weeks.FinalmeanAOFASscorewas77.8±10.0points.MeanVASscorewas1.8±0.8points.Posttraumaticarthritisdevelopedinonepatient.

Interpretation:

The modified lateral malleolar osteotomy provides excellent exposure and reliable fixation for talar body and tibial pilon fractures.

Limitations:

• Small sample size of five patients.
• Short follow-up duration of 18–40 months.

Conclusion:

The modified lateral malleolar osteotomy approach is technically straightforward and yields acceptable short-term outcomes for complex ankle fractures.