Intra-articular Fractures of the Distal Tibia

Abstract

Patients (42) with pilon fractures were followed 24 to 96 (mean, 53) mo. post-fracture. Fractures were classified as type I (26%), type II (29%) or type III (45%) as defined by Ruedi and Allgower. Type I fractures were usually torsional in nature whereas type II and III injuries were usually the result of a fall from a height or motor vehicle accident. Type I and II pilon fractures were amenable to anatomic open reduction and stable internal fixation, and 80% or more had satisfactory results. Only 44% of type III fractures treated by open reduction and internal fixation produced a satisfactory outcome. Nonanatomic reduction, unstable fixation, infection, nonunion and/or angulation were the usual causes of failure of this form of treatment.