A 42-Year-Old Male with Ankle Swelling and Pain, Pilon Fracture
Pilon fracture A pilon fracture (also known as a tibial plafond fracture ) is a complex and often severe injury involving the distal end of the tibia, typically extending into the weight-bearing surface of the ankle joint. 1. Cause A pilon fracture is typically caused by high-energy axial loading , such as: Motor vehicle collisions Falls from significant heights (landing on feet) Industrial accidents Low-energy mechanisms (e.g., simple ankle twists) can also cause pilon fractures in osteoporotic or elderly patients, but are less common. 2. Etiology The etiology is directly related to axial compressive forces that drive the talus into the distal tibial articular surface, causing: Comminution of the tibial plafond Disruption of the metaphysis and joint congruity Soft tissue damage , including skin, ligaments, and muscles The mechanism of injury is crucial in determining the severity: Axial load + valgus/varus rotation...