Arthroscopically Assisted Reconstruction and Percutaneous Screw Fixation of a Pilon Tibial Malunion

We report a case of distal tibial fracture (AO 43-C3) originally treated with close reduction and ligamentotaxis, which was seen at our institution at 6 weeks with malunion of the medial malleolus. It was successfully treated with arthroscopy-assisted mobilization of the malunion with subsequent percutaneous reduction and fixation. Four months after surgery, with an American Orthopedic Foot and Ankle Society score of 100, the patient felt no pain when walking. Techniques and postoperative treatment are described.