If the pieces are aligned and stable, nonsurgical treatment may effectively heal the fracture. 21,23 In addition, while mental component scores are equivalent to age-matched norms 6 months. 20 Type C pilon fracture patients experience worse health outcomes than those with tibial plateau or pelvic fractures, acute myocardial infarction, or AIDS. Pilon fractures are injuries that occur at the lower end of the tibia and involve the weight bearing surface of the ankle joint. Whether or not your doctor recommends surgery often depends on how out of place (displaced) the fractured pieces of bone are. While fractures can safely be reduced using staged ORIF, reported functional recovery is poor. Many pilon fractures require surgery, but some stable fractures can be treated nonsurgically. ![]() Pilon fractures are most often caused by high-energy impacts such as fall from heights, skiing, motor vehicle/motorcycle collisions, etc. Pilon fractures may be considered high-energy ankle fractures.īecause of the energy required to cause this type of fracture, 25% to 50% of patients have additional injuries that require treatment. In many pilon fractures, the bones of the ankle joint are crushed due to the high-energy impact causing the injury. This book chapter from StatPearls provides an overview of the anatomy, classification, diagnosis, treatment, and complications of ankle fractures, with a focus on evidence-based practice and current guidelines. They can range from simple to complex, depending on the number and location of the broken bones. Pilon is a French word for pestle, an instrument used for crushing or pounding. Ankle fractures are common injuries that can affect people of all ages and activity levels. In most cases, both bones in the lower leg, the tibia and fibula, are broken near the ankle. If arthritis develops at a later stage, you may require a procedure called arthrodesis which involves fusion of the bones in the ankle.Pilon fractures affect the bottom of the shinbone (tibia) at the ankle joint. If a fibula fracture is present, it is also repaired. It is performed through one or more incisions and involves placing the fractured tibial plafond back in its anatomic position and stabilizing it with screws and plates. Surgery is indicated for most tibial plafond fractures after the swelling has subsided. Your fracture may be externally stabilized in a frame if there is significant soft tissue injury to allow the tissues to heal. Ankle Large Left Full length tibia and fibula articulated to the talus, calcaneus and forefoot with a 4-part pilon fracture and distal fibula fracture. ![]() Pilon fracture usually results from high energy axial loading trauma, e.g. A Pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. Your doctor may treat a tibial plafond fracture by nonsurgical methods with a cast or splint for 10 to 12 weeks, if the fracture is not displaced or your health does not permit surgery. Pilon Fracture This injury is the comminuted fracture of the tibial plafond (distal end of the tibia, including the articular surface). Their classification was derived from the evaluation of rotational injuries sustained following skiing accidents. Rüedi and Allgöwer were one of the first to describe pilon fractures. Pain and swelling is controlled with medication, ice application, elevation of your foot or application of a temporary splint. Mechanism of Injury and Classification Systems. Imaging studies of the fibula, spine and hip are also ordered to check for associated injuries.Įmergency treatment includes irrigation of the open wound and administration of antibiotics to control infection. When you present to the clinic with a pilon fracture, your doctor performs a physical examination of the area of injury for disruption of skin, and to assess nerves and blood supply, X-rays and a CT scan of the ankle are ordered. The fractured bone may disrupt the skin, resulting in an open fracture, which needs to be treated emergently due to the possibility of infection. Tibial plafond or pilon fractures are usually accompanied by pain, swelling, deformity and inability to bear weight. ![]() The fracture is often accompanied by damage to soft tissue, articular cartilage and underlying bone, which can lead to post-traumatic arthritis. Fractures of the tibial plafond are rare, occurring as a result of a fall from a height or a motor vehicle accident that forces the ankle up against the tibia, often causing the bone to shatter. The part of the tibia that articulates with the talus (ankle bone) is called the tibial plafond or pilon. The tibia and fibula are long shin bones, which articulate with the thigh bone on one end and ankle joint at the lower end. This approach to repair of tibial pilon fractures, and resultant prevention of posttraumatic ankle arthritis, has been shown to provide satisfactory symptomatic. Home » Conditions » Adult Trauma » Tibial Plafond Fracture Tibial Plafond Fracture
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