Pilon fracture

Case contributed by Subhan Iqbal
Diagnosis certain

Presentation

Motor vehicle accident.

Patient Data

Age: 30 years
Gender: Male
x-ray

The fracture involves the tibial plafond and the distal tibial articular surface. Associated transverse fractures of the fibula is also seen. 

Case Discussion

Pilon fracture is a type of distal tibial fracture involving the tibial plafond. Typically high energy injuries and occur as a result of an axial loading which drives the talus into the tibial plafond.

According to Ruedi and Allgower classification system:

  • 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

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

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