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A pilon fracture, is a
fracture Fracture is the separation of an object or material into two or more pieces under the action of stress. The fracture of a solid usually occurs due to the development of certain displacement discontinuity surfaces within the solid. If a displa ...
of the
distal Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position pro ...
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. 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. 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 Étienne Destot (1 March 1864 – 3 December 1918) was a French radiologist and anatomist who was a native of Dijon. He studied medicine in Lyon, and later worked in the hospitals of Hôtel Dieu, Croix-Rousse and Charité in Lyon. In additio ...
.


Classification

Pilon fractures are categorized by two main X-ray schemes, Ruedi-Allgower classification system. and Müller AO Classification of fractures.


Treatment

The treatment of pilon fractures depends on the extent of the injury. This includes the involvement of other bones such as the fibula and the talus, involvement of soft tissue, and the fracture pattern. Treatment strategies and fixation methods used include internal and external fixation, as well as staged approaches, with the aim of reducing the fracture, reconstructing the involved bones and restoration of articular surface congruence, with minimal insult to soft tissues. Appropriate wound management is important to reduce the high rate of infectious complications and secondary wound healing problems associated with open pilon fractures. Vacuum-assisted wound closure therapy and using a ''staged protocol'' (awaiting soft-tissue recovery before extensive reconstructive efforts) may play a positive role.


See also

* Ankle fracture


References


External links

{{Fractures , state=autocollapse Bone fractures Medical terminology