Plain XR and CT of a displaced comminuted pilon fracture. There is no commonly used classification of pilon fractures, but a simple classification is that of Ruedi & Allgower: Type I: undisplaced; Type II: displaced but not comminuted Fractures were classified by six evaluators (three foot and ankle surgeons and three orthopaedic surgery residents) using CT scans according to the morphological grading of the new pilon fracture classification system developed by Leonetti et al. Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. 20-25% are open . Last modified Apr 05, 2012 09:33 ver. The pilon fracture was first described by Destot (1) in 1911. The CT shows the five common fragments (anterior, posterior, medial, anterolateral and die-punch). This article addresses pilon fractures—a specific type of fracture that occurs in the lower leg near the ankle. Pilon Fractures George S. Gumann Justin J. Fleming The opinions of the authors are their private views and are not to be considered as representative of official policy of the U.S. Army Medical Department. Pilon Fractures Philip Wolinsky . In: OrthopaedicsOne - The Orthopaedic Knowledge Network. Spectrum of injuries: 1) Low energy rotational fx’s Ankle type fractures / Skiing, simple falls . University of California at Davis Medical Center . Despite the best treatment, patients sustaining high-energy pilon fractures generally do not return to their previous state of general health or function. Type-III fractures are the most frequent presentation, comprising approximately 25% to 71% of all pilon fractures. In 2017, Leonetti and Tigani published a new classification system of pilon fractures based on CT. – Determined by fracture pattern and “primary” injury Pilon Fractures • Post‐op Care – Make it protocol – Strict elevation post‐op: 23 hrs/day Source. After recovery from pilon fractures, many patients continue to … “The operative treatment of intra-articular fractures of the lower end of the tibia.” Clin Orthop Relat Res (138): 105-110. In the AO/OTA classification for long bone fractures, pilon fractures are classified as extra-articular (43A), partial articular (43B), and intra-articular (43C), and further subclassified based on the degree of comminution. Retrieved Pilon (tibial plafond) fractures - Ruedi and Allgower classification. METHODS: One hundred and ten cases (107 patients) of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. Reference: Ruedi, T. P. and M. Allgower (1979). KEY FACTS • The tibial pilon fracture is a rare, yet devastating injury. Background Distal tibia fracture with intra-articular extension . 1/3 of patients have associated injuries . To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle).. A pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. 236. According to the four-column classification scheme, lateral column of 85 cases, posterior column of 66 cases, medial column of 77 cases, and anterior column of 61 cases are involved. The new system divides pilon fractures according to 4 labeling factors: 1) if the articular surface is involved, 2) the number of articular fragments, 3) the direction of major fracture line, and 4) areas of comminution. The new classification system was simple, all inclusive and easily to remember. Like Neer classification for proximal humerus fractures, this classification divides the pilon fracture in 4 groups according to the number of the fragments at the joint level. A pilon fracture involves the distal tibial metaphysis with extension… OrthopaedicsOne Articles. Created Apr 04, 2012 02:40. 1-10% of LE fx’s . 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