Discussion: - term pilon (hammer) fracture was introduced to describe these compression injuries by Destot in 1911; - frx components: - combination of ankle frx & distal tibial metaphyseal frx, usually w/ intra articular comminution; - frx of medial malleolus; - frx of anterior margin of tibia; - transverse frx of posterior tibial surface; - 20-25% of these will be open

AONA posting of the AO Classification of Long Bone Fractures Highly Reputable

High energy intraarticular fractures of the distal tibia (tibial plafond fractures, or pilon fractures) present a great challenge to the orthopaedic surgeon. These injuries often result in a significant soft tissue damage, comminution of bone, and disruption of the articular cartilage and subchondral bone. The treatment strategy used in dealing with tibial plafond fractures is strongly influenced by the often-precarious soft tissue conditions. Due to the great treatment challenges posed by this high-energy injury, there has been much controversy about the most appropriate and best treatment for tibial plafond fractures. Factors such as timing of treatment, method of stabilization, techniques of operative care, and postoperative rehabilitation have all been hotly debated and, at times, contested by various orthopaedists. This chapter will attempt to comprehensively address the anatomy, physiology, and diagnosis of this injury; it will also discuss various treatment modalities, and the importance of tailoring treatment to the extent of the bony and soft tissue injuries.

Archive Copy 2004: University of Alabama Trauma Protocol

This module shows step-by-step descriptions of

• Diagnosis
• Patient preparation
• Approaches
• Reduction & fixation
• Aftercare

 
for all malleolar fractures of the AO classification system.
In addition, there are videos, animations, journal articles and book chapters.
 
Authored by Paulo Barbosa, Felix Bonnaire, Kodi Kojima, Executive editor: Chris Colton

Ankle Fracture Classification Expert

Weber C Expert

Talus Fractures Expert

Dealing with Bone Loss Determining Optimal Position Acheiving adequate fixation Issues of instability Patient expectations vs. long term results Expert

Wheeless' Textbook of Orthopaedics

Includes short introduction, differentials, findings (including X-rays), and a bibliography. Free, but requires registration. Peer Reviewed eMedicine article

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Wheeless' Textbook of Orthopaedics

Archive Copy 2003: Internet based research project investigating the value and reproducibility of ankle fracture classification systems. University of Virginia Institute of Applied Biomechanics

Wheeless' Textbook of Orthopaedics