Pilon

Pilon Fractures

A Pilon fracture or plafond fracture is a type of fracture of the distal part of the tibia, involving its articular surface at the ankle joint. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. They are rare, comprising 3 to 10 percent of all fractures of the tibia and 1 percent of all lower extremity fractures.

Classification

Pilon fractures can be classified using the Ruedi-Allgower classification or the AO/OTA classification. The Ruedi-Allgower classification is simpler and divides pilon fractures into three types based on the degree of comminution and displacement. The AO/OTA classification is more complex and divides pilon fractures into three types based on the location of the fracture and the degree of articular involvement.

Symptoms and Diagnosis

Patients with a pilon fracture typically present with severe pain, inability to bear weight, and swelling at the ankle joint. The diagnosis is confirmed by X-ray imaging, which shows the fracture and any associated injuries. Computed tomography (CT) scan may be used for further evaluation of the fracture and planning of the surgery.

Treatment

The treatment of pilon fractures is challenging due to the complexity of the fracture and the poor soft tissue coverage in this area. The goal of treatment is to restore the normal alignment and stability of the ankle joint, and to allow early mobilization to prevent stiffness and loss of function. Treatment options include non-surgical treatment with casting or splinting, and surgical treatment with open reduction and internal fixation (ORIF) or external fixation.

Prognosis

The prognosis of pilon fractures is generally poor due to the high risk of complications, including infection, nonunion, malunion, arthritis, and loss of function. The outcome is better in younger patients with less severe fractures and in those who receive early and appropriate treatment.

See also

• Tibia
• Fracture
• Ankle joint
• Computed tomography (CT)

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