Fractures of the Tibial Plafond

High-energy fractures of the tibial plafond are a lifechanging event for the patient. Currently, open reduction and internal fixation (ORIF) appears to offer the best chance for obtaining and maintaining anatomic articular reduction and axial alignment to union. Definitive ORIF should be performed in a staged fashion to allow adequate resolution of the associated soft tissue injury. A preoperative plan is essential to a successful outcome and it must include a strategy to access and stabilize the articular and nonarticular components of the injury.