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PILON FRACTURES

Dr Prakashappa T. H.Professor , S.I.T. OBENGALURE

Historical perspectiveThe termtibial pilonwas first used by DESTOT in 1911,likening the pilon to the pestle. Pilon is french word for pestle,an instrument used for crushing or pounding,

1911; DESTOT-term PILON was used1960(early); BONNIER-1960 Non operative treatment GAY - 19631965(late 60s); Roudie\Allgower-ORIF1980-1990 ; Bournie-1983 ; Teeny\wiss -1990--- High complication with ORIF poor respect to the soft tissues by operating on d3-5 Early 90s- Tornetta-1993 Wyrsch-1995----------Ex Fix with limited ORIFLate 90s-2000-Sirkin 1999 Patterson 1999-------Staged protocal- early temporary Ex Fix and delayed ORIF

What is pilon fracture?All the fractures of the distal tibia involving the distal articular surface should be classified as pilon fractures except medial,lateral & trimalleolar fractures where the posterior malleolus is< 1\3 of the articular surface If isolated fracture of the posterior malleolus which is > 1/3 of articular surface should also called as pilon fracture.

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OBJECTIVESOVERVIEW (anatomy;epidemiology;mechanism)EVALUATION (cinical;physical and imaging)CLASSIFICATIONSASSOCIATED IJURIESTREATEMENTCOMPLICATIONS

ANATOMYTIBIAL PILON; Distal end of Tibia including articular surfaceProximal limit of tibial pilon;8 to 10 cm from the tibial articular surface

EXCLUDING BI-MALLEOLAR &TRIMALLEOLAR#RES

EPIDIOMOLOGYAccounts for approximately 5-7% of all tibial fractures

Accounts for