Mazzitelli G, et al. - Via this retrospective analysis, researchers sought to report clinical and radiographic results of treatment of 14 patients with complex open pilon fractures treated between 2010 and 2015. An AO type 43C fracture was observed in all patients. Three Gustilo Type IIIA injuries, seven Type III B and four Type III C were observed. Fracture healing was observed in the mean time period of 6.3 months. Definitive treatment with external fixation was performed in 4 patients at the time of the initial irrigation and debridement. Delayed definitive surgery was done in 10 patients; ORIF was used in 10 patients. Four patients (28%) underwent soft-tissue coverage by vascularized muscle flap on the day of definitive fixation. Iliac crest bone-grafting was required by one patient. Outcomes suggest intensive debridement, antibiotics, adequate devices and patient-tailored timing of definitive surgical treatment as effective in safely managing these fractures with a low rate of complications.