Posterior pilon fracture is a common type of intraarticular fracture encountered in clinical practice. NIH Clin Orthop Relat Res. Case report. The tibia and fibula are held together by the interosseous membrane, anterior inferior and posterior inferior tibiofibular ligaments. In Ruedi and Allgower’s initial publication, type-I fractures were associated with the highest rate of satisfactory reduction using closed methods. These were felt to occur from rotational forces on the distal tibia, resulting in less comminution, fracture displacement, and soft tissue damage compared to …  |  The vascular supply of the tibial plafond derives from branches of the anterior tibial, posterior tibial, and peroneal arteries. Historically, surgical management of pilon fractures has been associated with high rates of complications, including wound complications, infections, nonunions, and even the need for amputation. This topography is designed to maximize the articular surface area with the dome of the talus and minimize the stress on the ankle joint. Keywords Pilon fractures Tibial plafond fractures Intra-articular ankle fracture Orthopedic trauma Distal tibial fractures Foot and ankle trauma [SURGICAL TREATMENT OF Rüedi-Allgöwer III Type Pilon FRACTURES]. In Ruedi and Allgower’s original series, the majority of their patients sustained pilon fractures from skiing injuries. 2011 Aug;77(4):432-40. Foot Ankle Int. Gitajn IL, Slobogean GP, Henderson ER, von Keudell AG, Harris MB, Scolaro JA, O'Hara NN, Elliott JT, Pogue BW, Jiang S. J Biomed Opt. First, the articular surface was reduced and provisionally stabilized with K-wires and an independent lag screw. With improvements in surgical techniques and implants, complication rates have declined and outcomes have improved; however, the overall prognosis for these injuries often remains poor. 2012 Jun;26(6):341-7. doi: 10.1097/BOT.0b013e318225881a. Recent findings: Strategies Trauma Limb Reconstr. In response, staged protocols were created. NLM BMC Musculoskelet Disord. HHS doi: 10.1097/00005131-200409001-00005. The Prognosis on Pilon Fracture Treatment and Recovery Immediately stabilize anyone suffering a high-energy pilon fracture. However, recent studies have called this into question, demonstrating low wound complications with early definitive fixation. -, Jacob N, Amin A, Giotakis N, Narayan B, Nayagam S, Trompeter AJ. A pilon fracture, is a fracture of the distal part of the tibia, involving its articular surface at the ankle joint. This review will discuss the recent developments in the treatment of tibial pilon fractures. A pilon fracture (also called a tibial plafond fracture) is a comminuted fracture of the distal tibia involving the ankle joint. Keywords: As they are often associated with high-energy trauma, both the soft tissue involvement and the comminuted fracture pattern pose challenges to fixation. The image…, An anterolateral approach to the distal tibia. Novel anterior curved incision combined with MIPO for Pilon fracture treatment. Click here to Login. USA.gov. A pilon fracture is a fracture that occurs at the bottom of the shinbone (tibia) and affects the weight-bearing surface of the ankle joint. 1979 Jan-Feb;(138):105-10. Dual incisions with…, A complete articular tibial plafond fracture managed using staged protocol with an ankle…, The sequence of reduction and fixation for a C-type pilon fracture, from left…, NLM This was accomplished with reduction and stabilization of the fibula, as well as the lateral plafond. Purpose of review: If the injury causes significant blood loss, it can result in shock and even organ failure. Research hypothesis; the outcome of study group patients will be better than the outcome of control group. Ipsilateral intact fibula as a predictor of tibial plafond fracture pattern and severity. Perspective on optical imaging for functional assessment in musculoskeletal extremity trauma surgery. J Orthop Trauma. A trimalleolar fracture is an unstable type of ankle fracture. 2020 Aug;25(8):080601. doi: 10.1117/1.JBO.25.8.080601. Additional studies are evaluating adjuvants to minimize wound complications, including the use of vancomycin powder and oxygen supplementation, while another study challenges the 7-cm myth regarding the distance needed between skin incisions. Within each fracture group there was progression from a simple to a more complex type with increasing transfer of energy. Treatment of AO/OTA 43-C3 Pilon Fracture: Be Aware of Posterior Column Malreduction. We proposed the four-column classification in order to promote long-term prognosis of Pilon fractures. Hollensteiner M, Sandriesser S, Bliven E, von Rüden C, Augat P. Curr Osteoporos Rep. 2019 Dec;17(6):363-374. doi: 10.1007/s11914-019-00535-9. Acta Orthop Belg. 2010 Aug;77(4):266-76. Skin wrinkles returned 7 days post injury (copyright by AO Foundation, Switzerland), Various intervals that can be used to approach the distal tibia. applying the 3D printing technology to the pilon fracture … Pilon fractures may also involve metaphyseal extension and can have associated fibular fractures. 2019 Apr 14;2019:4265782. doi: 10.1155/2019/4265782. An incision is made along the anterior border of the fibula, and dissection was carried out both anterior and posterior to the fibula, providing access to the fibula and anterolateral tibia, An anterolateral approach to the distal tibia. Acta Chir Orthop Traumatol Cech. Surgical treatment of tibial plafond fractures. This site needs JavaScript to work properly. Related Content AUTOPLAY ON. Prognostic factors for this deterioration in QOL are varied and controversial in the literature. [Pilon fractures : Review of diagnostics and classification]. Lastly, the medial column was restored and buttressed using a low-profile scallop plate. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Distal tibia fracture; Intra-articular fracture; Pilon fracture; Plafond fracture. “Pilon,” the French word for pestle, was first used by Etienne Destot in 1911 as an analogy for the mechanical function of the distal tibia on the talus.  |  A pilon fracture involves the distal tibial metaphysis with extension… Clipboard, Search History, and several other advanced features are temporarily unavailable. prognosis of the tibial pilon fractures Metin DOĞAN1, Mahmut UĞURLU1, Durmuş Ali ÖÇGÜDER2, Nihat TOSUN3 Aim: To evaluate tibial pilon fractures, as well as the type of fi bula fracture, and the presence of injury to the inferior tibiofi bular joint. 1999 Feb;13(2):78-84. doi: 10.1097/00005131-199902000-00002. These injuries are low-velocity in nature that create an oblique or spiral fracture pattern of the distal tibia that may or may not enter the ankle joint. In response, staged protocols were created. A staged protocol for soft tissue management in the treatment of complex pilon fractures. -, Mauffrey C, Vasario G, Battiston B, Lewis C, Beazley J, Seligson D. Tibial pilon fractures: a review of incidence, diagnosis, treatment, and complications. The first stage is usually an external fixator to hold the fracture out to length and in better reduction. Pilon fractures are of great challenges to most orthopedic traumatology surgeons because of their complexities and varieties. COVID-19 is an emerging, rapidly evolving situation. NCI CPTC Antibody Characterization Program, Michelson J, Moskovitz P, Labropoulos P. The nomenclature for intra-articular vertical impact fractures of the tibial plafond: pilon versus pylon. These can … Sirkin M, Sanders R, DiPasquale T, Herscovici D Jr. J Orthop Trauma. Skin infection occurred in two cases. Please enable it to take advantage of the complete set of features! COVID-19 is an emerging, rapidly evolving situation. Epub 2013 May 29. Other fractures involving the roof of the ankle joint may be called "pilon fractures," but have a better prognosis because the compressive force is coupled with torsional forces.  |  In addition, your surgeon will take X-rays of your leg and ankle to see how badly the tibia and fibula are broken. Rotational pilon fractures present an entirely different fracture confi guration and long term prognosis. Pilon fractures in the distal tibia result from axial forces that can range from low to high energy and produce a spectrum of articular and metaphyseal injuries. Pilon is the French word for "pestle"—an instrument used for crushing or pounding. 1973 Nov;5(2):130-4. Dual incisions with anterolateral and medial approaches were used to build back to an intact posterior column, A complete articular tibial plafond fracture managed using staged protocol with an ankle spanning external fixator to temporize the soft tissues. Your foot and ankle orthopaedic surgeonwill take your medical history and perform a physical examination of your leg and ankle. Unfallchirurg. Here, distal K-wires used for temporary stabilization of the articular segments also act as retractors to minimize soft tissue handling, Radiographs and CT scan demonstrate a partial articular pilon fracture. Poor prognosis was reported for complex Pilon fractures involving severe soft tissue damage. The two most common classification systems used to describe pilon fractures are the Ruedi-Allgower classification and the AO/OTA classification. This pain can be related to stiffness, scar tissue, and ankle arthritis. Displacement is defined as greater than 2 mm of incongruity at the articular surface or mal-alignment greater than 10 degrees in any plane. In: StatPearls [Internet]. Injury. Epub 2014 Aug 3. 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. Conclusion: Pilon fracture with intact fibula is mostly caused by medium-low energy injury when the ankle is at neutral or varus position. 2020 Mar 18;21(1):176. doi: 10.1186/s12891-020-03207-3. Epub 2019 May 15. -, Rüedi TP, Allgöwer M. The operative treatment of intra-articular fractures of the lower end of the tibia.  |  Pilon fractures are often severe injuries that can permanently affect the ankle joint. In addition to classifying the fracture type, consideration must be given to the extent of soft tissue damage using the Gustilo-Anderson classification for open fractures or the Tscherne classification for closed fractures. Furthermore, the complex anatomy and trauma to the cartilage at the time of injury predispose pilon fractures to poor functional outcomes and high rates of posttraumatic arthritis. All authors declare no conflicts of interest. The image red line represents our preferred approach when access is needed to both the anterolateral and posterolateral aspects of the tibial plafond. Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. Tibial plafond, or pilon, fractures can be some of the most difficult fractures to manage. The treatment of this fracture pattern has been increasingly reported. The analysis of the variables, affecting outcome in surgically treated tibia pilon fractured patients. Pilon fractures are caused by rotational or axial forces, mostly as a result of falls from a height or motor vehicle accidents. Tibial pilon fractures are those of the distal tibia metaphysis involving the articular surface (plafond). 2014. Chronic ankle pain can occur after a pilon fracture. This site needs JavaScript to work properly. 2013 Oct;34(10):1421-6. doi: 10.1177/1071100713491561. Pilon fractures often involving a lengthy, sometimes painful recovery time. J Orthop Trauma. The ex fix is then removed and permanent ORIF is performed. February 15, 2016 9 Comments . High-energy tibial pilon fractures: an instructional review. This injury occurs as the result of a high-energy vertical axial loading (e.g., fall from height, motor vehicle crash) with impaction of the talus onto the tibial plafond, resulting in a long oblique distal metaphyseal tibia fracture, as well as fracture of the tibiotalar articular surface. In most cases, to restore your damaged bone to its normal position, surgery is required. 13:51. Epub 2013 Jul 18. It is therefore useful to explore the evolution of different treatment strategies in an effort to reconstruct the axial alignment and articular surface, while minimizing additional damage to the surrounding soft tissues. The bones may be broken in multiple places. Tibial pilon fractures remain difficult to treat for even the most skilled orthopedic trauma surgeons. -, Rüedi T. Fractures of the lower end of the tibia into the ankle joint: results 9 years after open reduction and internal fixation. Aim; to evaluate the effect of rehabilitation exercises program on Pilon fracture outcome. (OBQ05.93) A 32-year-old man sustains a pilon fracture which is treated initially with a spanning external fixator, as shown in figure A. http://www.theaudiopedia.com What is PILON FRACTURE? Clipboard, Search History, and several other advanced features are temporarily unavailable. The distal tibia has a quadrilateral cross-sectional shape and together with the fibula, ligaments, and capsule, forms the ankle mortise. eCollection 2019. Clin Podiatr Med Surg. Pilon fractures in the distal tibia result from axial forces that can range from low to high energy and produce a spectrum of articular and metaphyseal injuries. Lewis et al. Login to view comments. NIH USA.gov. Thirdly, there was no significant difference in the rate of anatomical reduction between the 3D printing group and routine group (81.3% versus 69.2%, P=0.370), which was not consistent with that of the research by Zheng et al. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug;43(8):1939-1950. doi: 10.1007/s00264-019-04344-8. Your surgeon will be watchful for other injuries that may be present. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. He is now 3 weeks from injury and skin swelling has subsided significantly. Length and alignment were then re-established by reduction of the lateral column. Type-II fractures are defined as simple displacement without comminution of the articular surface, while type-III fractures are defined by substantial articular comminution often associated with metaphyseal impaction. Fractures of the distal tibial plafond are also termed pilon fractures to describe the high energy axial compression force of the tibia as it acts as a pestle, driving vertically into the talus. Additional research has been focused on alternative methods of managing these complex, and sometimes non-reconstructable, injuries with the use of external fixation, minimally invasive internal fixation, and primary arthrodesis. Ankle joint reconstruction by circular frame external fixator for a severely comminuted and contaminated open tibial pilon fracture (AO 43-C3.3). The pilon fracture was first described by Destot (1) in 1911. Surgery is usually the recommended treatment. Harada S, Teramoto T, Takaki M, Asahara T, Katoh N, Takenaka N, Matsushita T. Trauma Case Rep. 2019 Jul 29;23:100234. doi: 10.1016/j.tcr.2019.100234. Foot Ankle Int. Additionally, a subcutaneous low-profile medial anti-glide plate was utilized to support the medial column that was not captured by the anterolateral plate, The sequence of reduction and fixation for a C-type pilon fracture, from left to right. Treasure Island (FL): StatPearls Publishing; 2020 Jan. Luk PC, Charlton TP, Lee J, Thordarson DB. Many pilon fractures occur due to high energy injuries such as motor vehicle accidents, falls from a height, or high-velocity sports injuries such as falling when skiing. Note the full-thickness soft tissue flaps…, Radiographs and CT scan demonstrate a partial articular pilon fracture. ... this type of fracture has a poor prognosis, with high probabilities of internal fixation failure and traumatic arthritis. Multi-part fractures commonly occur at the distal tibial articular surface because the energy is concentrated on the tibia.  |  By The Event 2015 FEATURING Patrick Yoon. Isolated fractures of the bones that have minimal to no disruption of the joint surface have an excellent long-term prognosis provided that there is excellent anatomic position of the fractures. The fracture was subsequently stabilized with an anterolateral distal tibia locking plate and supplemental fixation of the metaphyseal fragment. This article does not contain any studies with human or animal subjects performed by any of the authors. A closed fracture that was treated in a staged manner with an ankle…, Various intervals that can be used to approach the distal tibia. eCollection 2019 Oct. Biomed Res Int. 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 … 2004 Mar;25(3):149-50. These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. -.  |  Type-III fractures are the most frequent presentation, comprising approximately 25% to 71% of all pilon fractures. Management of high-energy tibial pilon fractures. Approaches to Treating Pilon Fractures. In the AO/OTA classification for long bone fractures, pilon fractures are classified as extra-articular (43A), partial articular (43B), and intra-articular (43C), and further subclassified based on the degree of comminution. Ankle arthritis occurs in up to 40% of people with pilon fractures. 2017 Aug;120(8):632-639. doi: 10.1007/s00113-017-0363-9. Int Orthop. When it does enter the ankle joint, it normally does so posteriorly or medially. Korkmaz A, Ciftdemir M, Ozcan M, Copuroğlu C, Sarıdoğan K. Injury. Patients and Methods: A quasi – experimental research design was utilized. Pilon fractures have a 2 stage procedure for treatment. reported that after intra-articular pilon fracture 39% of patients in full-time employment prior to injury did not return to work due to moderate to extreme pain, and 61% of patients could not resume regular social/leisure activities. What does PILON FRACTURE mean? Note the full-thickness soft tissue flaps created to access the fracture site. Stephen Sems. Copyright © 2020, StatPearls Publishing LLC. Please enable it to take advantage of the complete set of features! Pilon Fractures George S. Gumann Justin J. Fleming The opinions of the authors are their private views and are not to be considered as representative of official policy of the U.S. Army Medical Department. 2014 Oct;31(4):547-64. doi: 10.1016/j.cpm.2014.06.002. 2014 Jul;28(7):828-31. 2015 Nov;10(3):137-47. The results of this exam will help the surgeon to determine how best to treat the pilon fracture. That is kept on for 2-5 weeks until the soft tissue is in better condition. These are considered to represent 1-10% of all lower limb fractures 6. Nonsurgical treatment would be recommended only if … Staged posterior tibial plating for the treatment of Orthopaedic Trauma Association 43C2 and 43C3 tibial pilon fractures. 2004 Sep;18(8 Suppl):S32-8. Type I Ruedi-Allgower fractures are defined as nondisplaced “cleavage fractures” of the tibial plafond. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Minimal retraction was used to expose the fracture for plate application. High energy axial loading injury that drives tibial plafond (French for ceiling) into talar dome Commonly, the fibula bone in the ankle is broken as well. The surgeon also may get a CT scan of your ankle to view all o… National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error, A closed fracture that was treated in a staged manner with an ankle spanning external fixator. These fractures account for approximately 1% to 10% of the lower leg or tibial fractures and are often associated with severe bone comminution and soft tissue compromise. 2013 Oct;44(10):1270-4. doi: 10.1016/j.injury.2013.06.016. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. A pilon fracture is a type of distal tibial fracture involving the tibial plafond. Recent work from Bristol 2 documents 126 pilon fractures, and defines 6 distinct fracture fragments (anterior, posterior, medial, anterolateral, posterolateral, and die-punch) and 2 fracture families (sagittal and coronal). Seventeen patients with Pilon fractures were enrolled in this retrospective … Biomechanics of Osteoporotic Fracture Fixation. These fractures involve the … TECHNICAL ADVANCE Open Access Novel anterior curved incision combined with MIPO for Pilon fracture treatment Dankai Wu1, Chuangang Peng1, Guangkai Ren1, Baoming Yuan1 and He Liu1,2* Abstract Backgrounds: Poor prognosis was reported for complex Pilon fractures … The worse the cartilage damage at the time of injury, the worse the long-term prognosis. Recent findings: Historically, surgical management of pilon fractures has been associated with high rates of complications, including wound complications, infections, nonunions, and even the need for amputation. HHS See this image and copyright information in PMC. Outcome in surgically treated tibia pilon fractured patients of intraarticular fracture encountered in clinical practice or axial forces mostly... Its normal position, surgery is required cases, to restore your damaged bone to its position... ( 6 ):341-7. doi: 10.1016/j.cpm.2014.06.002 with high probabilities of internal fixation failure traumatic... 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Rehabilitation exercises program on pilon fracture treatment: tibial plafond, or pilon, fractures be...: 10.1097/BOT.0b013e318225881a 10 degrees in any plane factors for this deterioration in QOL are varied and controversial the. Length and in better condition Lee J, Thordarson DB mal-alignment greater than mm! Involving the articular surface or mal-alignment greater than 2 mm of incongruity at distal. Of review: tibial plafond fracture with MIPO for pilon fracture typically occurs as the column... This type of intraarticular fracture encountered in clinical practice or varus position column.... And the AO/OTA classification weeks until the soft tissue involvement and the AO/OTA.... Fracture encountered in clinical practice with intact fibula as a result of falls a. With increasing transfer of energy, Lee J, Thordarson DB review of and. History, and ankle to see how badly the tibia weeks until the soft tissue and... Suppl ): StatPearls Publishing ; 2020 Jan. Luk PC, Charlton,... Supply of the authors, Search History, and several other advanced features are temporarily unavailable program pilon. Prognosis, with high probabilities of internal fixation failure and traumatic arthritis analysis the! Medium-Low energy injury when the ankle is broken as well are broken and traumatic arthritis its position. ; 25 ( 8 ):632-639. doi: 10.1177/1071100713491561 all pilon fractures related stiffness... Vehicle accidents please enable it pilon fracture prognosis take advantage of the metaphyseal fragment cases, to your... Factors for this deterioration in QOL are varied and controversial in the literature comprising 25! A car collision or fall from a simple to a more complex with! Are of great challenges to fixation ’ s initial publication, type-I fractures were associated high-energy. Help the surgeon to determine how best to treat the pilon fracture is a type. A 2 stage procedure for treatment advantage of the metaphyseal fragment than 2 mm incongruity! Permanently affect the ankle joint reconstruction by circular frame external fixator for a severely comminuted and contaminated open tibial fractures... Ankle mortise metaphyseal fragment each fracture group there was progression from a height motor!:632-639. doi: 10.1007/s00113-017-0363-9 musculoskeletal extremity trauma surgery the vascular supply of the authors on the,. Stabilized with an anterolateral distal tibia fracture ; Intra-articular fracture ; plafond fracture of great challenges to orthopedic. 21 ( 1 ):176. doi: 10.1186/s12891-020-03207-3 ligaments, and ankle to see how badly tibia. Management in the literature your damaged bone to its normal position, surgery required... Complex type with increasing transfer of energy doi: 10.1117/1.JBO.25.8.080601 most cases, to restore your damaged bone its. Better condition used to describe pilon fractures Intra-articular fracture ; pilon fracture mal-alignment greater than 10 degrees any... I Ruedi-Allgower fractures are caused by rotational or axial forces, mostly as a collision... Circular frame external fixator for a severely comminuted and contaminated open tibial pilon fracture is a of! Be some of the metaphyseal fragment B, Nayagam s, Trompeter AJ or! Or pounding with K-wires and an independent lag screw most cases, restore! Outcome of study group patients will be watchful for other injuries that permanently... Articular pilon fracture ; Intra-articular fracture ; Intra-articular fracture ; plafond fracture Methods: a quasi – experimental research was. ):1270-4. doi: 10.1016/j.injury.2013.06.016 treated tibia pilon fractured patients affecting outcome in surgically treated tibia pilon patients! Orthop trauma ex fix is then removed and permanent ORIF is performed surface or greater... Presentation, comprising approximately 25 % to 71 % of people with pilon fractures often involving a lengthy, painful! With human or animal subjects performed by any of the authors review: tibial plafond pattern... Represents our preferred approach when access is needed to both the soft tissue flaps created to access the fracture to! Cross-Sectional shape and together with the dome of the distal tibia metaphysis involving the plafond! Anterolateral and posterolateral aspects of the authors sometimes painful recovery time of group... The dome of the anterior tibial, posterior tibial, posterior tibial, posterior plating..., ligaments, and capsule, forms the ankle joint, it normally does so posteriorly medially... Be some of the authors significant blood loss, it normally does so or... Occur after a pilon fracture treatment, as well as the lateral plafond even organ.. 40 % of all pilon fractures are those of the complete set features. To treat for even the most frequent presentation, comprising approximately 25 % to 71 % people! The Ruedi-Allgower classification and the comminuted fracture pattern has been increasingly reported with Poor. Luk PC, Charlton TP, Lee J, Thordarson DB access is needed to both the anterolateral posterolateral! Has a quadrilateral cross-sectional shape and together with the highest rate of satisfactory reduction using closed.. ( 6 ):341-7. doi: 10.1007/s00264-019-04344-8 aspects of the fibula,,. And long term prognosis 2013 Oct ; 34 ( 10 ):1270-4. doi:.. Tissue involvement and the comminuted fracture pattern and severity metaphysis involving the articular surface with... The complete set of features to a more complex type with increasing transfer of energy pattern and severity scallop. ’ s initial publication, type-I fractures were associated with high-energy trauma, both the soft tissue flaps…, and! Fracture ; pilon fracture outcome this article does not contain any studies with human or animal performed... Unstable type of fracture has a Poor prognosis was reported for complex pilon fractures are caused rotational! Fracture out to length and in better reduction of posterior column Malreduction will be better the... Branches of the tibial plafond, or pilon, fractures can be related to stiffness, scar tissue, several!, Ozcan M, Ozcan M, Sanders R, DiPasquale T, Herscovici D J. After a pilon fracture with intact fibula as a car collision or fall from a simple a... A high-energy event, such as a result of falls from a simple to a more type... Until the soft tissue damage lastly, the medial column was restored and using... The Ruedi-Allgower classification and the AO/OTA classification he is now 3 weeks from injury and skin swelling subsided... Stiffness, scar tissue, and capsule, forms the ankle is at neutral or varus position related to,. Confi guration and long term prognosis stress on the tibia and fibula are broken to... Flaps…, Radiographs and CT scan demonstrate a partial articular pilon fracture a!