TOPIC: RANDOM MIX
For a high-energy, closed, significantly displaced tibial pilon fracture (OTA/AO 43-C3) accompanied by severe soft tissue swelling and clear fracture blisters, what is the most universally accepted protocol regarding surgical timing and initial intervention?
A
Immediate, definitive single-stage open reduction and internal fixation within 6 hours to prevent full-thickness skin necrosis
B
Urgent limited open reduction of the fibula followed by delayed definitive percutaneous fixation of the tibia at 3 to 4 weeks
C
Immediate application of a spanning external fixator across the ankle joint, followed by definitive internal fixation once soft tissues have completely recovered (typically 10-21 days)
D
Primary tibiotalar arthrodesis utilizing a retrograde intramedullary nail, given the inherently poor long-term outcomes of ORIF for this fracture pattern