Distal Tibia (Pilon) Fractures

• DR. HELFET:
212-606-1888

• DR. LORICH:
212-746-4509

• DR. WEILAND:
212-606-1575

• DR. POSITANO:
212-606-1858

A 42 year-old male slipped and fell approximately 14 feet while working on a ladder onto his extended right leg. He was taken to our Emergency Department and radiographs revealed a right-sided displaced distal tibial pilon fracture with extensive articular comminution and associated displaced fibula fracture with significant soft tissue swelling. A spanning external fixator was placed for initial treatment followed by Open Reduction and Internal Fixation (ORIF) of his fibula fracture with placement of a 7-hole locking plate to achieve restoration of length. ORIF of the pilon fracture was performed at 3 weeks following adequate resolution of the soft tissue swelling and the fracture was reduced and fixed and 2 locking plates and screws were placed. He returned for follow-up visits at regular intervals and at 5 months following the index surgery radiographs revealed a healed distal tibial pilon fracture in good alignment and he reported resolution of pain and return to pre-injury activities.

IMAGES

Figure A A Anteroposterior (AP) and lateral radiographs illustrating a right-sided displaced distal tibial pilon fracture with extensive articular comminution and associated displaced fibula fracture and (right images) fluoroscopic and AP x-ray following placement of external fixation and ORIF of the fibula fracture.

Figure B CT scan images further delineating the fracture pattern and pre-operative surgical plan.

Figure C Radiographs at 5 months following the index surgery reveal a healed distal tibia pilon fracture in excellent alignment with maintenance of reduction and fixation.