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Pilon Fracture

Medical term: Tibial Plafond Fracture

Overview

A pilon fracture is a break in the distal tibial articular surface, the weight-bearing dome of the ankle joint. These fractures are typically caused by axial loading injuries such as falls from height, motor vehicle accidents, or skiing crashes, where the talus is driven upward into the tibial plafond. The result is often a comminuted fracture with significant damage to the joint surface and surrounding soft tissues.

Pilon fractures are among the most challenging injuries that orthopedic trauma surgeons treat. The combination of articular damage, soft tissue swelling, and bone comminution requires a careful, often staged surgical approach. Our San Diego trauma team has specialized expertise in managing these complex injuries, using advanced techniques including CT-guided surgical planning, staged fixation protocols, and meticulous soft tissue handling to achieve the best possible outcomes.

Frequently Asked Questions

What is a pilon fracture?
A pilon fracture is a break in the weight-bearing surface of the distal tibia at the ankle joint. These high-energy injuries typically involve significant damage to the joint surface, surrounding cartilage, and soft tissues.
Why is pilon fracture surgery often staged?
Pilon fractures cause severe soft tissue swelling. Staged treatment, often starting with an external fixator to restore length and alignment, allows the swelling to subside before definitive plate fixation, reducing the risk of wound complications.
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