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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.
Typically high energy injuries and occur as a result of an axial loading which drives the talus into the tibial plafond.
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
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
History and etymology
Derived from the French word pilon (pestle), an instrument used for crushing and pounding and usually used with a mortar.