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Pilon fracture

A pilon fracture is a type of fracture involving the distal tibia. These are considered to represent 1 - 10% of all lower limb fractures6


Typically occurs as a result of an axial loading injury which drives the talus into the tibial plafond.


Several classification systems exist. Frequently adopted is the one proposed by Ruedi and Algower 5

  • type I : articular fracture with minimal or no displacement
  • type II : displacement of the articular surface but with minimal or no comminution. 
  • type III : marked comminution as well as articular impaction

Radiographic features

Plain film / CT

Exact features vary with type, but commonly:

  • fractures lines are seen extending into the tibiotalar articular surface.
  • oblique fracture components may extend proximally into the tibial shaft.
  • depending in the severity, fractures may also involve the fibula.


Derived from the French word pilon (pestle), an instrument used for crushing and pounding and usually used with a mortar.

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