Post-traumatic osteoarthritis (PTOA) is an all-too-common outcome after intra-articular fracture (IAF), even after best efforts at surgical fracture reduction. To lessen the risk of PTOA in this context, we need to know what causes PTOA development and how we can prevent or mitigate these risk factors. Chronically elevated joint contact stress has been shown to be a risk factor for PTOA progression in a joint after IAF (Anderson et al. 2011). Above a certain threshold of contact stress-time exposure, a joint is more likely to develop PTOA. In an effort to limit the contact stress exposure that the distal tibial articular surface experiences after an IAF of the tibial pilon, this study explores the potential for prescribing a custom dynamic orthosis (CDO). CDOs have been shown to reduce pain and improve ankle function after IAFs of the ankle (Bedigrew et al. 2014). CDOs also have the potential to reduce contact stress by reducing the ankle joint moment, offloading the ankle joint itself and its attenuating impact of the tibia during gait. A CDO with these characteristics might have the capacity to be customized to specific patient needs, based off the incongruity remaining on the surgically reduced tibial pilon.