Tibial Pilon Fracture-with Intact fibula

Courtesy : Prof Nabile Ebraheim, University of Toledo, Ohio, USA

• A pilon fracture ( or tibial plafond fracture) is a fracture of the distal tibia involving the ankle joint and it typically fractures the fibula.
• Pilon is a French term of the injury mechanism meaning “hammer” or “pestle”.
• A pilon fracture is a high energy trauma with articular impaction and comminution.
• There will be significant associated soft tissue injury and metaphyseal bone loss with associated muscloskeletal injuries.
• Usually the fibula is fractured along with the pilon fracture but occasionally remains intact.
• Fracture usually occurs with an anterolateral fragment that subluxes or dislocates from the joint and remains attached to the fibula.
• The syndesmosis is injured. There will be talofibular joint incongruity due to disruption of the talofibular ligament.
• The fibula appears longer and moving laterally. Oblique views show the direction of the force.