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Pilon fracture management

Pilon or tibial Plafond fracture is an intra-articular fracture of the tibiotalar joint with varying degrees of proximal extension into the tibial metaphysis. They represent less than 5% of all lower extremity fractures and less than 10% of all tibial fractures. High-energy axial force is the usual mechanism of injury which also produces severe soft-tissue damage. The main problem with such fractures is the extensive damage to the thin soft tissue envelope, degree of comminution, malunion and non-union. This is due to fact that the vascularity of the soft tissue sleeve of the distal tibia is tenuous. Various methods have been introduced for the treatment of such fractures such as open reduction internal fixation (ORIF) with plate osteosynthesis, external fixation or primary arthrodesis of the ankle joint. A great deal of controversy still exists as to the optimal management of such injuries. In this retrospective study, we aim to present our experience from a tertiary level one trauma centre on these relatively uncommon fractures.


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