58 patients with high-energy pilon fractures were randomized to evaluate the efficacy of locking plates against convention nonlocking plates, over 1 year. Radiographic data was evaluated for loss of reduction using Mortise/ AP and lateral radiographs of the ankle, and functional outcomes were assessed using ankle hindfoot scores, and Short Musculoskeletal Function Assessment (SMFA). The evidence presented in this study demonstrates that both treatments perform comparably in each outcome measurement, but the authors of the study indicate that the results may suffer from type II error due to the low incidence of reduction loss.