tibial plafond fracture
• Also known as pilon fractures
• Epidemiology
◦ incidence
account for <10% of lower extremity injuries
incidence increasing as survival rates after motor vehicle collisions increase
◦ demographics
average patient age is 35-40 years
more common in males than females
• Pathophysiology
◦ mechanism
high energy axial load (motor vehicle accidents, falls from height)
◦ pathoanatomy
often characterized by
articular impaction and comminution
metaphyseal bone comminution
soft tissue injury (open or Tscherne II/III closed fractures)
associated musculoskeletal injuries
3 fragments typical with intact ankle ligaments
medial malleolar (deltoid ligament)
posterolateral/Volkmann fragment (posterior inferior tibiofibular ligament)
anterolateral/Chaput fragment (anterior inferior tibiofibular ligament)
• Associated conditions
◦ 75% have associated fibula fractures
• Prognosis
◦ parameters that correlate with a poor clinical outcome and inability to return to work
lower level of education
pre-existing medical comorbidities
male sex
work-related injuries
lower income levels