My Orthopaedic Surgeon

Discussion: - term pilon (hammer) fracture was introduced to describe these compression injuries by Destot in 1911; - fracture components: - combination of ankle fracture & distal tibial metaphyseal fracture, usually with intra articular comminution; - fracture of medial malleolus; - fracture of anterior margin of tibia; - transverse fracture of posterior tibial surface; - 20-25% of these will be open

High energy intraarticular fractures of the distal tibia (tibial plafond fractures, or pilon fractures) present a great challenge to the orthopaedic surgeon. These injuries often result in a significant soft tissue damage, comminution of bone, and disruption of the articular cartilage and subchondral bone. The treatment strategy used in dealing with tibial plafond fractures is strongly influenced by the often-precarious soft tissue conditions. Due to the great treatment challenges posed by this high-energy injury, there has been much controversy about the most appropriate and best treatment for tibial plafond fractures. Factors such as timing of treatment, method of stabilization, techniques of operative care, and postoperative rehabilitation have all been hotly debated and, at times, contested by various orthopaedists. This chapter will attempt to comprehensively address the anatomy, physiology, and diagnosis of this injury; it will also discuss various treatment modalities, and the importance of tailoring treatment to the extent of the bony and soft tissue injuries.

Archive Copy 2004: University of Alabama Trauma Protocol

Report from 16th Annual meeting of the OTA contains sections on
A distal tibia/pilon fractures
B Calcaneus Fractures
C Talus Fractures
D Ankle Fractures