Distal tibia (pilon) fractures
A 42-year-old male slipped and fell approximately 14 feet while working on a ladder onto his right lower extremity.
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 resolution of the soft tissue swelling and the fracture was reduced and fixed. Two locking plates and screws were placed laterally and anteriorly.
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.
Figure AAnteroposterior (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.
Tags: Tibia Fracture