His injury mechanism isn't typical for a true pilon fracture, but if accounts are accurate that is a rough injury. Especially if it was an open fracture with the increased risk of infection. I saw a postop picture, they did an ex fix which will allow the swelling to decrease, and then definitive fixation with plate/screws/nail depending on fracture pattern sometime within the next couple of weeks. Short term he may get back to near his pre-injury form, but there are a lot of questions and variables that are unknown.

Long term is a different discussion. He'll almost 100% certainly have some significant post-traumatic arthritis, especially at a younger age. Total ankle arthroplasty has a lifespan of around 10 years, possibly a little longer for the newer types. Meaning a lot of docs don't want to do an ankle replacement in a 30 or 40 year old patient who may live until 80-90 years old and possibly would need multiple revision surgeries. The other main option for a patient with end stage ankle joint arthritis is joint fusion (again, not something you are super excited to do in a younger patient, but not a lot of other options).

A lot of discussion about CTE and long term effects of repeated traumatic brain injuries, but we don't often hear a lot about the long-term sequelae of musculoskeletal injuries and how debilitating they can be. Ask Alex Smith about that one.

Definitely puts things in a little more perspective when you see guys retire at an earlier age, hard to blame them with all the stress that is put on their bodies.