A pilon frarcture is a break at the bottom of the tibia. Typically the fibula is also broken with this type of injury. A pilon fracture commonly occurs as a result of a high-energy event, like a car crash, fall or sudden impact. Pilon means “pestle” in French, which is an instrument used for crushing or pounding. In most pilon fractures the bone is crushed into several pieces.
Anatomy
The two bones that make up the lower leg are the tibia (shinbone) and the fibula. The talus is a small bone in the foot that functions as a hinge between the tibia and fibula. Together the fibula, tibia and talus create the ankle joint.
Cause
Pilon fractures vary depending on the intensity of the event. The tibia can break in one place or shatter into several pieces. The injury’s severity depended on the number of fractures and size of the broken bone fragments. Injuries where the surrounding soft tissue is also damaged can be more intense. Pilon fractures occur during high-energy trauma. These fractures have increased as air bags have become more popular in cars. Air bags do not protect the legs so survivors often suffer with pilon fractures and other leg injuries.
Symptoms
Pilon fractures typically bring about immediate and severe pain. Most patients also report swelling, tenderness, bruising, deformities and decreased mobility.
Treatment
Typically patients who suffer from pilon fractures will immediately go to urgent care or an emergency room because of the severity of their symptoms. Most fractures require surgery but some can be treated with nonsurgical treatments. Whether or not you receive surgery as your treatment depends on how displaced the fractured bones are.
Nonsurgical treatments for stable fractures include minimal walking and a splint or cast. Most doctors will apply a splint to hold your ankle in place. The doctor will then replace the splint with a short leg cast that is correctly fitted so it can provide support. As the swelling goes down in your ankle you may need to change casts.
Surgery for unstable fractures reposition the bone fragments into their normal alignment. They are then held together with screws and metal plates.
You will most likely start moving your ankle again after 2 to 5 weeks. However, how soon you begin movement again depends on your doctor.
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