In: OrthopaedicsOne - The Orthopaedic Knowledge Network. The pilon fracture was first described by Destot (1) in 1911. After recovery from pilon fractures, many patients continue to … 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. In 2017, Leonetti and Tigani published a new classification system of pilon fractures based on CT. Pilon (tibial plafond) fractures - Ruedi and Allgower classification. 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. Retrieved KEY FACTS • The tibial pilon fracture is a rare, yet devastating injury. Last modified Apr 05, 2012 09:33 ver. 1/3 of patients have associated injuries . A pilon fracture involves the distal tibial metaphysis with extension… 1-10% of LE fx’s . Pilon Fractures • Approaches & Technique – Beyond this scope – Anteromedial, anterolateral, posterior, anterior, perc, MIPO, percwith IMN, ringed fixation, etc. The new classification system was simple, all inclusive and easily to remember. University of California at Davis Medical Center . 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. Background Distal tibia fracture with intra-articular extension . Plain XR and CT of a displaced comminuted pilon fracture. Type-III fractures are the most frequent presentation, comprising approximately 25% to 71% of all pilon fractures. 236. 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. “The operative treatment of intra-articular fractures of the lower end of the tibia.” Clin Orthop Relat Res (138): 105-110. Pilon Fractures Philip Wolinsky . 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. Created Apr 04, 2012 02:40. METHODS: One hundred and ten cases (107 patients) of Pilon fractures classified by the four-column theory and treated by ORIF, were reviewed. The CT shows the five common fragments (anterior, posterior, medial, anterolateral and die-punch). – Determined by fracture pattern and “primary” injury Pilon Fractures • Post‐op Care – Make it protocol – Strict elevation post‐op: 23 hrs/day Spectrum of injuries: 1) Low energy rotational fx’s Ankle type fractures / Skiing, simple falls . Despite the best treatment, patients sustaining high-energy pilon fractures generally do not return to their previous state of general health or function. OrthopaedicsOne Articles. 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. 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 20-25% are open . Reference: Ruedi, T. P. and M. Allgower (1979). 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