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Pilon Fractures What are they and how are they treated? By Staci Lorimer
What is a Pilon Fracture? Pilon is a French word for pestle, an instrument used for crushing or pounding. In many pilon fractures, the bones of the ankle joint are crushed due to the high-energy impact causing the injury. Pilon fractures may be considered high-energy ankle fractures. Pilon fractures affect the bottom of the shinbone (tibia) at the ankle joint. In most cases, both bones in the lower leg, the tibia and fibula, are broken near the ankle.
What is a Pilon Fracture? ,[object Object]
Fall from height
Motor vehicle/motorcycle collisions
Skiing
Risk Factors	Age. The average age of someone with a pilon fracture is 35 to 40 years old. Pilon fractures are rare in children and elderly people. However, as our population ages, seniors will account for a larger amount of these fractures.  	Male. Men are three times more likely than women to have pilon fractures A pilon fracture often affects both bones of the lower leg.
How Does the Patient Present? Immediate and severe pain  Swelling  Bruising  Tender to the touch  Cannot put any weight on the injured foot  Deformity ("out of place")—your ankle looks angled or crooked
How Does the Patient Present? ,[object Object]
The doctor will check for sensation and look for a pulse to make sure there is blood supply to the foot and ankle. He or she will also check for swelling, which may determine if and when surgery can be done.To fully evaluate the fracture, your doctor may recommend an x-ray (left), a CAT scan (center), or a three-dimensional CAT scan (right).
Surgical Procedures ,[object Object]
If  there is significant swelling or blisters, the doctor will delay surgery until the swelling goes down. Surgery that is performed too early increases the risk for infection or problems with the incision.,[object Object]

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Pilon Fractures: How They're Treated and Long-Term Outcomes

  • 1. Pilon Fractures What are they and how are they treated? By Staci Lorimer
  • 2. What is a Pilon Fracture? Pilon is a French word for pestle, an instrument used for crushing or pounding. In many pilon fractures, the bones of the ankle joint are crushed due to the high-energy impact causing the injury. Pilon fractures may be considered high-energy ankle fractures. Pilon fractures affect the bottom of the shinbone (tibia) at the ankle joint. In most cases, both bones in the lower leg, the tibia and fibula, are broken near the ankle.
  • 3.
  • 7. Risk Factors Age. The average age of someone with a pilon fracture is 35 to 40 years old. Pilon fractures are rare in children and elderly people. However, as our population ages, seniors will account for a larger amount of these fractures. Male. Men are three times more likely than women to have pilon fractures A pilon fracture often affects both bones of the lower leg.
  • 8. How Does the Patient Present? Immediate and severe pain Swelling Bruising Tender to the touch Cannot put any weight on the injured foot Deformity ("out of place")—your ankle looks angled or crooked
  • 9.
  • 10. The doctor will check for sensation and look for a pulse to make sure there is blood supply to the foot and ankle. He or she will also check for swelling, which may determine if and when surgery can be done.To fully evaluate the fracture, your doctor may recommend an x-ray (left), a CAT scan (center), or a three-dimensional CAT scan (right).
  • 11.
  • 12.
  • 13.
  • 14. Outcome Study Methods: Fifty-six ankles (fifty-two patients) with a tibialplafond fracture were treated with a uniform technique consistingof application of a monolateral hinged transarticular externalfixator coupled with screw fixation of the articular surface.Thirty-one patients with thirty-five involved ankles returnedbetween five and twelve years after the injury for a physicalexamination, assessment of ankle pain and function with theIowa Ankle Score and Ankle Osteoarthritis Scale.
  • 15.