Pilon fractures (or tibial plafond fractures) are severe injuries to the ankle. They are usually caused by high-energy events that occur alongside other injuries to the leg and ankle.
At Orthopaedic Associates of Zanesville, our orthopedic surgeons provide expert treatment for pilon fractures of the ankle in Zanesville, Ohio. Contact us today to schedule an appointment.
A pilon fracture refers to a broken bone at the bottom of the tibia (shinbone). It affects the weight-bearing surface of the ankle joint. These types of fractures are usually caused by high-energy impact, such as a fall from height or a high-speed car crash.
The name of this type of fracture comes from the French word for pestle. This is the word for the cooking utensil used to crush spices in a mortar. Due to the nature of the injury, pilon fractures usually cause the tibia bone to be crushed or splinter into several pieces, known as a comminuted fracture.
Surgery is usually required to realign broken bone pieces and hold them in their normal position. If the bone breaks the skin, it is called an open fracture and requires immediate attention to prevent infection. It is common for both the tibia and fibula to break due to the high energy involved.
Most pilon fractures happen when there is a high-energy force transferred through your lower leg. Common events include falls from height, motorcycle accidents, or skiing accidents. Pilon fractures caused by low-impact events are possible if the person has osteoporosis or compromised bone strength.
A pilon fracture usually causes immediate and severe pain. You may also experience the following symptoms:
Most patients will go straight to an urgent care or emergency room for pilon fractures because of how they occurred. Patients may have additional injuries that need to be treated as well. Your doctor will begin by discussing your symptoms and medical history. They will then perform a physical examination.
During the physical exam, your doctor will determine where the pain is coming from, check for nerve damage, and check your pulse to see if there is a good blood supply in your ankle and foot. They will also perform a general check to see if you have any other injuries from the trauma event. Your doctor will also order imaging tests to evaluate the severity of the fracture. This may include an X-ray or CT scan.
Many Pilon fractures require surgery to restore the bone pieces to their correct position and keep them in place while the fracture heals through internal or external fixation. Nonsurgical treatment may be sufficient if the bone pieces are not displaced.
Nonsurgical treatment may be recommended for stable fractures in which the pieces of bone are not displaced or minimally displaced.
It may also be recommended for patients who do not walk much or who are at higher risk of surgical complications. For example, patients with severe osteoporosis, heart disease, or other medical concerns may not be able to tolerate surgery.
Nonsurgical treatment may include the following:
Surgery is often required for unstable fractures. Pilon fracture surgery may include the following procedures:
Following surgery, you will be given medication for pain. This will help you to recover more quickly. You may also be given a blood thinner to prevent blood clots.
Sometime between 2 and 6 weeks, you will be able to move your ankle. The timing will depend on the type of fracture and the treatment decided by your doctor.
Weight bearing is usually not possible until after 2-3 months. You may need to use crutches, a cane, or a walker to get around until you’re cleared.
Physical therapy will begin as soon as you’re cleared to move your ankle. You will be given a removable cast or brace to make it easier to do the exercises. Exercises will help you restore the range of motion in your ankle. After about 6 weeks, you will be given exercises to strengthen the supporting muscles.
Many people can return to pre-injury activity following a pilon fracture of the ankle. Your recovery time will depend on the severity of your injury, your activity level, and whether you sustained other injuries at the same time.
If your work involves manual labor, you may need 4-6 months for recovery. If you participate in high-impact sports, you may need 6 months of recovery. Improvements may continue for up to 2 years following an injury.
If you’re seeking emergency treatment for a pilon fracture of the ankle or any other fractures, then make your way to our urgent orthopaedic care facility in Zanesville, Ohio. Our orthopaedic surgeons at Orthopaedic Associates of Zanesville can provide the care and attention you need. Contact us today!
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A pilon fracture is a break at the bottom of the tibia (shinbone) that affects the ankle joint. These injuries often occur during high-impact events such as car accidents or falls from height and may also involve a fracture of the fibula.
Patients with pilon fractures typically experience severe pain, swelling, bruising, tenderness, inability to bear weight, and visible deformity around the ankle.
Not all pilon fractures require surgery. Stable fractures with minimal displacement may be treated with splints, casts, and close monitoring. However, unstable fractures often require surgery to realign and stabilize the bones.
Surgery usually involves repositioning the bone fragments and securing them with plates and screws. In some cases, an external fixator may be used temporarily to stabilize the ankle before additional surgery.
Recovery varies depending on the severity of the injury. Most patients cannot bear weight for 2–3 months, and full recovery may take several months to up to two years for continued improvement.
