What is a tibial pilon fracture?
Tibial pilon fractures, also known as plafond fractures, are severe injuries affecting the distal tibia. They are caused by high energy axial loads as the tibial plafond is injured by the talus punching up into it.
What is the prevalence of a pilon fracture in the US?
Pilon fractures are rare, comprising 3 to 10 percent of all fractures of the tibia and 1 percent of all lower extremity fractures, but they involve a large part of the weight-bearing surface of the tibia in the ankle joint.
What is a type 1 pilon fracture?
Type I: A type I pilon fracture is an articular fracture (bone break in or around a joint) with minimal or no bone displacement (the broken bones are still aligned).
What is the prognosis of pilon fracture of the ankle?
After recovery from pilon fractures, many patients continue to have debilitating pain and ankle stiffness (Babis et al 1997, Sands et al 1998, Pollak et al 2003). Fortunately, pilon fractures compose a minority of tibia or lower extremity fractures, occurring in ~ 7% and 1% of all cases, respectively.
Can you fully recover from a pilon fracture?
Most pilon fractures require surgery. It usually takes three to six months after surgery for the fracture to heal completely. However, it often takes individuals a year or more to fully recover from the injury.
Can a pilon fracture heal without surgery?
Some pilon fractures do not need surgical treatment. These are typically lower-energy injuries to the tibia and fibula at the ankle joint. The bones are broken but simply shifted out of place and these injuries tend to be less severe. These lower-energy pilon fractures can be treated with a leg cast.
How do they repair a pilon fracture?
Your doctor may apply an external fixator to hold your pilon fracture in place and stabilize your ankle until your second surgery can take place. An external fixator may be applied to protect your foot until it is safe to perform a second surgery to repair the fracture.
Where is the tibial plafond located?
A tibial plafond fracture (also called a tibial pilon fracture) occurs at the end of the shin bone and involves the ankle joint. As is the case with tibial plateau fractures, these injuries occur close to the joint and must be treated with the cartilage surface of the ankle joint in mind.
When does Pilon start?
PILON rules Under the statutory notice rules, an employee has to receive a minimum of one week's notice for every full year that they have been employed by their employer, up to a maximum of 12 weeks. If they have been employed for less than one year, but more than four weeks, they are entitled to one week's notice.
How long is tibial plateau fracture surgery?
Surgical Treatment Sometimes bone graft or types of bone cement are needed to support the joint surface. During these surgeries injured meniscus or tendons are repaired as well. Surgery usually takes 1 to 2 hours.
What is the most common ankle fracture?
The most common fracture is to the bony bump on the outside of the ankle, the lateral malleolus. The lateral malleolus is the bottom of the fibula, the smaller lower leg bone. The bump on the inside of your ankle, the medial malleolus, is less commonly fractured.
Is a pilon fracture part of a Trimalleolar fracture?
Pylon fractures are a distinct clinical and radiologic entity that should not be confused with trimalleolar fractures.
Can you walk on a fractured fibula?
Because the fibula is not a weight-bearing bone, your doctor might allow you walk as the injury recovers. You also might be advised to use crutches, avoiding weight on the leg, until the bone heals because of the fibula's role in ankle stability.
What is the tibial Pilon?
A pilon fracture is a type of break of the shinbone (tibia) that happens near the ankle. Most of the time, it includes breaks in both the tibia and fibula of the lower leg. The lower ends of these bones make up part of the ankle. The term “pilon” comes from the French word for pestle. This is a tool used for crushing.
What does tibial plafond mean?
Description. Tibial plafond (“pilon”) fractures involve the distal articular surface of the tibia and extend to the metaphysis. Term first introduced as description of the distal tibial metaphysis—pestle-shaped “pilon” Plafond (French for “ceiling”) refers to the horizontal distal tibial articular surface.
What is the plafond of the tibia?
The distal articular surface of the tibia is also referred to as the plafond, originating from the French “plat” (meaning flat) and “fond” (meaning bottom).
Can you walk on a fractured fibula?
Because the fibula is not a weight-bearing bone, your doctor might allow you walk as the injury recovers. You also might be advised to use crutches, avoiding weight on the leg, until the bone heals because of the fibula's role in ankle stability.
Is a pilon fracture part of a Trimalleolar fracture?
Pylon fractures are a distinct clinical and radiologic entity that should not be confused with trimalleolar fractures.
How long does it take for a fibula bone to heal?
It and the tibia, the larger bone, therefore, support all of your weight when standing. Because of this and unlike other types of injuries and conditions, a broken fibula usually requires six weeks to three months before patients are able to return to their normal routine.
How does a broken talus bone heal?
How do you fix a broken talus? Some talus fractures can be corrected by casting and rehabilitation. However, most talus fractures require surgery to correct the alignment of your bones. A talus fracture is a painful injury usually caused by a high-impact accident such as a car accident or fall.
What is a pilon?
Pilon is a French term used to describe a fracture of the distal tibia usually characterized by high-energy traits, including dissociation of the articular surface from the tibia shaft. Destot coined the term pilon, as he thought that the distal tibial metaphysis resembled a pharmacist’s pestle.
Where do pilon fractures exit?
In the vast majority of pilon fractures, the fracture lines propagate from the fibular incisura laterally in the shape of a Y to exit anterior and posterior to the medial malleolus.
What are the complications of a tibial pilon fracture?
Other common complications seen following treatment of tibial pilon fractures are arthrofibrosis and posttraumatic arthritis.
What is the pain after a pilon fracture?
After recovery from pilon fractures, many patients continue to have debilitating pain and ankle stiffness. Pilon fractures can occur from both low- and high-energy mechanisms. The pilon fracture usually has an anterolateral (Chaput) fragment and a posterolateral (Volkmann) fragment.
What is the roof of the ankle called?
Plafond is also a French term, described by Bonin, referring to the distal tibial articular surface as the roof (ceiling) of the ankle joint.
What is the purpose of splinting in the emergency room?
Initial splinting in the emergency room decreases further soft tissue trauma, and fracture dislocations should be reduced with adequate anesthesia to restore joint alignment.
Can you return to your previous state after a pilon fracture?
Despite the best treatment, patients sustaining high-energy pilon fractures generally do not return to their previous state of general health or function. After recovery from pilon fractures, many patients continue to have debilitating pain and ankle stiffness (Babis et al 1997, Sands et al 1998, Pollak et al 2003).
What is a tibial pilon fracture?
A tibial pilon fracture is a break at the bottom or distal portion of the tibia, more common ly known as the shinbone. A tibial pilon fracture can be a result of impact from a fall, a twist, or a car accident. Typically, the fibula (the smaller ankle bone in the lower leg, parallel to the tibia) will also break when a tibial pilon fracture occurs. Tibial pilon fractures are less common than an ankle fracture which involves a rotational injury to the foot, breaking the fibula and / or tibia. A tibial pilon fracture involves the weight bearing portion of the distal tibia. Our physicians have extensive experience treating tibial pilon fractures, especially those caused by skiing and snowboarding injuries.
How are tibial pilon fractures treated?
Our physicians may apply a splint or cast to the lower leg to hold the fracture in place. A walking boot may be fitted, or a cast, after the swelling subsides. Healing can take approximately twelve weeks.
What is the result of a fractured tibia?
When the tibia bone breaks through the skin, the result is a compound or “open” fracture. Such an injury requires urgent surgery to correct. Frequently, an external fixation device is applied to help correct and stabilize the broken bones. The symptoms of a tibial pilon fracture or broken shinbone are:
What to do if your tibia is broken?
If the tibia is not in its proper place, surgery may be recommended. Our physicians will evaluate the swelling and make a recommendation about surgery once the swelling has decreased. During surgery, our physicians will reposition (reduce) the displaced bone and bone fragments to their original form; internal fixation (rods, plates and screws) will be utilized to hold the fractures in place until they heal. This is called open reduction internal fixation, or ORIF. If an external fixation device was used, this is typically removed during the surgery. The correction may be done in one or two surgeries depending on the severity of the break. Typically, we prescribe a blood thinner to prevent blood clots in the leg during recovery.
What is a pilon?
Pilon is the French word for "pestle"—an instrument used for crushing or pounding. In many pilon fractures, the bone may be crushed or split into several pieces due to the high-energy impact that caused the injury. In most cases, surgery is needed to restore the damaged bone to its normal position.
How to stabilize a pilon fracture?
Your doctor may apply an external fixator to hold your pilon fracture in place and stabilize your ankle until your second surgery can take place.
What is the bone in the lower leg that is broken?
With this type of injury, the other bone in the lower leg, the fibula, is frequently broken as well. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. Pilon fractures are often severe injuries that can permanently affect the ankle joint.
How do you know if you have a pilon fracture?
Patients with pilon fractures usually experience immediate and severe pain. Other symptoms may include:
What are the bones that make up the ankle joint?
Fibula—smaller bone in the lower leg. The talus is a small foot bone that works as a hinge between the tibia and fibula. Together, these three bones—tibia, fibula, and talus—make up the ankle joint. The three bones that come together to form the ankle joint.
What causes a pinon fracture?
Pilon fractures most often result from high-energy trauma such as a car or motorcycle accident, fall from a height, or skiing accident.
Can you have a pilon fracture treated?
Many pilon fractures require surgery but, rarely, some stable fractures can be treated nonsurgically. Whether or not your doctor recommends surgery often depends on how out of place (displaced) the fractured pieces of bone are.
How long to leave a fractured pilon?
fractures with significant joint depression or displacement. leave until swelling resolves (generally 10-14 days) not always warranted in length stable pilon fractures. outcomes. placement of pins out of the zone of injury and planned surgical site is important to reduce infection risks.
What is a tibial fracture?
A tibial plafond fracture (also known as a pilon fracture) is a fracture of the distal end of the tibia, most commonly associated with comminution, intra-articular extension, and significant soft tissue injury.
How far should pins be from joint?
pins should be placed at least 1-2 cm from the joint line in order to avoid possible septic arthritis. safe zones for wire placement form a 60-degree arc in the medial-lateral plane. can include limited internal fixation if soft tissues permit. consider the need for soft tissue coverage with position of the fixator.
Overview
A pilon fracture is a relatively rare bone break that happens at the bottom of your tibia (the larger of the two bones in your lower leg, or your shinbone) near your ankle. In many cases of pilon fractures, the other bone in your lower leg, your fibula, is broken as well.
Diagnosis and Tests
Pilon fractures require X-rays in order to be diagnosed. Your healthcare team may have you undergo other imaging tests to learn more about your injury.
Living With
If you are experiencing signs and symptoms of a pilon fracture such as intense pain in your lower leg and ankle and having a crooked or deformed ankle, see a healthcare provider right away. If you can’t get to urgent care or an emergency room on your own, call 911 for help.
What type of fracture is a tibial pilon?
Generally, two types of tibial pilon fractures have been recognized. Rotational type fractures usually arise from a relatively low-energy, rotational force, similar to that which may occur during recreational. skiing. These fractures typically are spiral in nature and are.
How many types of tibial pilon fractures are there?
Generally, two types of tibial pilon fractures have been recognized.
Which portion of the tibia is commonly involved?
commonly involve the metaphyseal portion of the tibia. Signs and
What percentage of tibia fractures are pilon fractures?
Pilon fractures are rare, comprising 3 to 10 percent of all fractures of the tibia and 1 percent of all lower extremity fractures, but they involve a large part of the weight-bearing surface of the tibia in the ankle joint.
What is a pilon fracture?
Specialty. Orthopedic surgery. A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents.
What classification system is used for Pilon fractures?
Pilon fractures are categorized by two main X-ray schemes, Ruedi-Allgower classification system. and Müller AO Classification of fractures.
Why are pilons so difficult to fix?
Because of this, they may be difficult to fixate and are historically associated with high rates of complications and poor outcome. Pilon is the French word for "pestle" and was introduced into orthopedic literature in 1911 by pioneer French radiologist Étienne Destot.
