A, Comminuted pilon fracture with fibular fracture. B, Fibular length is restored and secured with six-hole plate as first step in reconstruction of pilon fracture. (From deSouza LJ: Fractures and dislocations about the ankle. In Gustilo RB, Kyle RF, Templeman DC, editors: Fractures and dislocations, St. Louis, 1993, Mosby.) SEE TECHNIQUE 54.7.