A Pilon Fracture, also known as Plafond Fracture, is a break or crack in the distal part of the tibia (shinbone) near the ankle. It is usually caused due to high impact injuries to the ankle, which cause the bones to crush into several pieces. In some cases, a Pilon Fracture may affect both the bones in the lower leg, tibia and fibula.
Mainly, Pilon Fractures can be categorized as:
- Type 1 Fracture: This is caused by low energy injuries in which the bone fragments are almost aligned and the joint surface is also appropriate.
- Type 2 Fracture: This is a moderate energy injury in which the joint surface becomes incongruous.
- Type 3 Fracture: This is a high impact injury in which the joint surface becomes inconsistent and the fracture extends up to the tibia.
- Fall from a height
- Motor vehicle injuries
- Sports related injuries
- Skiing accidents
- Direct blow to the lower leg near the ankle
- Severe pain
- Swelling in the lower leg and around ankle joint
- Bruising and discoloration near the ankle
- Tenderness on touch
- Formation of blisters
- Inability to stand or walk
- Visible deformity in the ankle joint
Most Pilon Fractures require surgery to be treated completely. However, for patients with certain health problems or minimal physical activity, conservative treatment may be recommended.
- Immobilization: If the broken bone pieces are stable and not entirely misaligned, the orthopedic doctor may immobilize the ankle with the help of a cast or splint. Once the swelling subsides, the cast may be substituted with a brace that need to be worn for around 8 to 10 weeks.
- Anti-Inflammatory Medications: The orthopedic doctor may prescribe certain anti-inflammatory medications to provide relief from pain and compress swelling.
- External Fixation: It may be recommended in Pilon Fractures involving considerable damage to soft tissues. Certain external fixation devices, such as metal frames or screws, are used to stabilize the bones and allow the soft tissues to heal.
- Internal Fixation: It may be suggested in type 2 or 3 fractures. Metal plates, screws or rods may be implanted to hold the tibia fragments in place till the time they heal.
- Ankle Fusion: Surgery may be recommended in severe case of Pilon Fractures where the bone fragments are completely out of place. During the procedure, the orthopedic surgeon may reposition the fractured bone pieces into their original place.