2. Patient is a 22 yo WM
Vitals: T: 97.8, HR: 78, RR: 16,
that presents to ED with
left ankle pain after a
skiing accident. Pt was
snow skiing and landed
on a rock after a jump
twisting his left ankle.
He has not been able to
walk on it since. Pt
denies any other injuries.
BP: 118/60
Gen: WD, WN, WM in NAD
CV: RRR
Pulm: CTA B
MSK: ttp over left ankle with
diffuse edema and abrasions.
2+ pulses. Good cap refill
Neuro: motor/sensory intact.
Pain with strength testing and
passive ROM.
3.
4. A pilon frcture, also known as a tibial plafond fracture,
and include a distal tibial metaphyseal fracture with
fracture of medial malleolus, anterior margin of tibia,
and transverse fx of posterior tibial surface.
5. Evaluate for neurovascular status
Reduce if necessary
Splint in posterior leg with stirrups
Immediate orthopedic surgery consult
Appropriate pain management
6. Pilon fractures are high-energy ankle fractures
Males 3x more likely than females
25%-50% of patients have additional injuries
Seen with falls from a height, MVC/MCC, skiing
Type classificiation from I – III depend on the amount
of articular comminution
CT scans are usually required to determine the plan for
surgical fixation
Associated with fibular fractures in the majority of
cases
7. Type III Pilon fracture
After repair of Pilon Fracture with
associated fibular fracture
8. http://www.fighttimes.com/magazine/magazine.asp?a
rticle=481
Tintinalli, Judith E., Gabor D. Kelen, and J. Stephan.
Stapczynski. Emergency Medicine: A Comprehensive
Study Guide. New York: McGraw-Hill, Medical Pub.
Division, 2004.
Wheeles, Clifford. "Wheelesonline.com."
Wheelesonline.com. Duke Orthopedics. Web. 04 June
2012. <http://www.wheelesonline.com/ortho>.