Pilon fractures are breaks occurring at the bottom of the tibia, also known at the shinbone, and affects the weight-bearing area of the ankle joint. A broken fibula also accompanies These injuries. Pilon fractures are commonly a result of a high-energy event. Car collisions or a sudden fall are the leading sources of pilon fractures. In French, pilon means pestle, which is an instrument for crushing. Most pilon fractures result in crushed or split bones. Surgery is necessary in most cases to reconfigure the damaged bones to its normal position.

The severity of pilon fractures depends on a variety of factors. The tibia may break in one location or break into several pieces. The severity of the injury depends on the number of fractures, how many pieces are displaced, the size of bone fragments and injury to the surrounding soft tissue. If the bones break through the foot, the fracture is considered an open compound fracture. These types of fractures are severe because infections can occur in the wound and bone.

Symptoms of pilon fractures include swelling, bruising, deformities and inability to bear weight. Nonsurgical treatments are effective for patients with bones still intact. They can also be helpful for patients who don’t walk frequently. Doctors apply splints or casts to hold the ankle in alignment. Surgery is recommended for unstable fractures that displace the bones. If the bone fragments are displaced, a doctor may choose to perform an open reduction and internal fixation. The doctor may also apply an external fixator to keep the pilon fracture in place to stabilize the ankle.

After the fracture has healed, the doctor may apply a removable cast or brace. Patients are prescribed physical therapy to improve the range of motion and strengthen the supporting muscles. After six to eight weeks patients may transition into regular shoes.