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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

Mechanism

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

Classification

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.

History and etymology

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

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