Pilon fracture
Last revised by Travis Fahrenhorst-Jones ◉ on 28 Dec 2022
Citation, DOI & article data
Citation:
Weerakkody Y, Fahrenhorst-Jones T, Lustosa L, et al. Pilon fracture. Reference article, Radiopaedia.org (Accessed on 08 Feb 2023) https://doi.org/10.53347/rID-10609
rID:
10609
Article created:
25 Aug 2010 by Yuranga Weerakkody ◉
Revisions:
30 times by 14 users - see full revision history
Systems:
Synonyms:
- Plafond fracture
- Tibial plafond fracture
- Pilon fracture of the distal tibia
- Pilon fractures
A pilon fracture is a type of distal tibial fracture involving the tibial plafond. These are considered to represent 1-10% of all lower limb fractures 6.
On this page:
Mechanism
Typically high energy injuries and occur as a result of an axial loading which drives the talus into the tibial plafond.
Classification
Several classification systems exist. Frequently adopted is the one proposed by Ruedi and Allgower 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 radiograph / CT
- by definition, the fracture involves the tibial plafond and the distal tibial articular surface
- associated fractures of the fibula can be evident, with or without ankle dislocation
- CT can further define the fracture pattern and assess for tendon subluxation
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History and etymology
Derived from the French word pilon (pestle), an instrument used for crushing and pounding and usually used with a mortar.
References
- 1. Cheung Y, Perrich KD, Gui J et-al. MRI of isolated distal fibular fractures with widened medial clear space on stressed radiographs: which ligaments are interrupted? AJR Am J Roentgenol. 2009;192 (1): W7-12. doi:10.2214/AJR.08.1092 - Pubmed citation
- 2. Topliss CJ, Jackson M, Atkins RM. Anatomy of pilon fractures of the distal tibia. J Bone Joint Surg Br. 2005;87 (5): 692-7. doi:10.1302/0301-620X.87B5.15982 - Pubmed citation
- 3. Haapamaki VV, Kiuru MJ, Koskinen SK. Ankle and foot injuries: analysis of MDCT findings. AJR Am J Roentgenol. 2004;183 (3): 615-22. AJR Am J Roentgenol (full text) - Pubmed citation
- 4. Tscherne H, Schatzker J. Major fractures of the pilon, the talus, and the calcaneus, current concepts of treatment. Springer Verlag. (1993) ISBN:0387558373. Read it at Google Books - Find it at Amazon
- 5. Chen SH, Wu PH, Lee YS. Long-term results of pilon fractures. Arch Orthop Trauma Surg. 2007;127 (1): 55-60. doi:10.1007/s00402-006-0225-3 - Pubmed citation
- 6. Sirkin M, Sanders R. The treatment of pilon fractures. Orthop. Clin. North Am. 2001;32 (1): 91-102. - Pubmed citation
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