Pilon Fractures

Pilon (tibial plafond) fractures involve articular distal tibial injury that result from high-energy axial load mechanisms that have a high association with polytraumatic injuries. Often the soft tissue damage is as traumatic as the associated bony injury. Similar to most orthopedic fracture management, knowledge of the important anatomic structures and energy dissipation will provide the basis for treatment of pilon fractures. Generally, surgical treatment is indicated and consists of temporary ankle-spanning external fixation for management of soft tissue compromise followed by delayed surgical open reduction and internal fixation. Complications are high with treatment of pilon fractures, and prognosis is worse than most other orthopedic injuries given high rates of infection, joint stiffness, and tibiotalar arthritis.