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Pilon Fracture
Corrie M. Yablon, MD; Julia R. Crim, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Definitions

              • Tibial plafond: horizontally oriented, weight-bearing articular surface of distal tibia
              • Pilon fracture (fx): tibial plafond fx due to high-energy axial loading or low-energy twisting mechanism

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            CLINICAL ISSUES

                            • Presentation

                              • Demographics

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Fischer B et al: Reconstruction of severe ankle and pilon fracture malunions. Foot Ankle Clin. 25(2):221-37, 2020
                                          2. Zelle BA et al: High-energy tibial pilon fractures: an instructional review. Int Orthop. 43(8):1939-50, 2019
                                          3. Kottmeier SA et al: Pilon fracture: preventing complications. J Am Acad Orthop Surg. 26(18):640-51, 2018
                                          4. Eastman JG et al: Entrapped posteromedial structures in pilon fractures. J Orthop Trauma. 28(9):528-33, 2014
                                          5. Cole PA et al: The pilon map: fracture lines and comminution zones in OTA/AO type 43C3 pilon fractures. J Orthop Trauma. 27(7):e152-6, 2013
                                          6. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                          7. Klammer G et al: Posterior pilon fractures: a retrospective case series and proposed classification system. Foot Ankle Int. 34(2):189-99, 2013
                                          8. Mandi DM et al: Pilon fractures. Clin Podiatr Med Surg. 29(2):243-78, viii, 2012
                                          9. Tarkin IS et al: An update on the management of high-energy pilon fractures. Injury. 39(2):142-54, 2008
                                          10. Chen SH et al: Long-term results of pilon fractures. Arch Orthop Trauma Surg. 127(1):55-60, 2007
                                          11. Topliss CJ et al: Anatomy of pilon fractures of the distal tibia. J Bone Joint Surg Br. 87(5):692-7, 2005
                                          12. Tornetta P 3rd et al: Axial computed tomography of pilon fractures. Clin Orthop Relat Res. (323):273-6, 1996
                                          13. Ruwe PA et al: Pilon fractures of the distal tibia. Orthop Rev. 22(9):987-96, 1993
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Definitions

                                                      • Tibial plafond: horizontally oriented, weight-bearing articular surface of distal tibia
                                                      • Pilon fracture (fx): tibial plafond fx due to high-energy axial loading or low-energy twisting mechanism

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Demographics

                                                                        • Natural History & Prognosis

                                                                          • Treatment

                                                                            DIAGNOSTIC CHECKLIST

                                                                            • Consider

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Fischer B et al: Reconstruction of severe ankle and pilon fracture malunions. Foot Ankle Clin. 25(2):221-37, 2020
                                                                                  2. Zelle BA et al: High-energy tibial pilon fractures: an instructional review. Int Orthop. 43(8):1939-50, 2019
                                                                                  3. Kottmeier SA et al: Pilon fracture: preventing complications. J Am Acad Orthop Surg. 26(18):640-51, 2018
                                                                                  4. Eastman JG et al: Entrapped posteromedial structures in pilon fractures. J Orthop Trauma. 28(9):528-33, 2014
                                                                                  5. Cole PA et al: The pilon map: fracture lines and comminution zones in OTA/AO type 43C3 pilon fractures. J Orthop Trauma. 27(7):e152-6, 2013
                                                                                  6. Crim J et al: CT assessment of the prevalence of retinacular injuries associated with hindfoot fractures. Skeletal Radiol. 42(4):487-92, 2013
                                                                                  7. Klammer G et al: Posterior pilon fractures: a retrospective case series and proposed classification system. Foot Ankle Int. 34(2):189-99, 2013
                                                                                  8. Mandi DM et al: Pilon fractures. Clin Podiatr Med Surg. 29(2):243-78, viii, 2012
                                                                                  9. Tarkin IS et al: An update on the management of high-energy pilon fractures. Injury. 39(2):142-54, 2008
                                                                                  10. Chen SH et al: Long-term results of pilon fractures. Arch Orthop Trauma Surg. 127(1):55-60, 2007
                                                                                  11. Topliss CJ et al: Anatomy of pilon fractures of the distal tibia. J Bone Joint Surg Br. 87(5):692-7, 2005
                                                                                  12. Tornetta P 3rd et al: Axial computed tomography of pilon fractures. Clin Orthop Relat Res. (323):273-6, 1996
                                                                                  13. Ruwe PA et al: Pilon fractures of the distal tibia. Orthop Rev. 22(9):987-96, 1993