What Is a Pilon Fracture of the Ankle?
A pilon fracture is a serious break near the bottom of the shinbone (tibia) where it meets the ankle joint. Many pilon fractures also involve the smaller bone of the lower leg, called the fibula.
Most pilon fractures happen after high-energy injuries, including falls from heights, motor vehicle accidents, and some sports injuries. Because the force is so severe, damage to nearby muscles, skin, and ligaments is also common.
Symptoms
Pilon fractures can cause significant pain and swelling right away. The ankle may appear misshapen or unstable after the injury.
Common symptoms include:
- Severe ankle pain
- Swelling and bruising
- Tenderness around the ankle
- Difficulty or inability to walk
- Deformity of the ankle or lower leg
- Limited movement in the ankle
How Is It Diagnosed?
Healthcare providers diagnose pilon fractures with a physical exam and imaging tests. Your provider will check for swelling, deformity, circulation problems, and other injuries.
Tests may include:
- X-rays
- CT scan
CT imaging helps providers see the fracture in greater detail and plan treatment if surgery is needed.
How Is It Treated?
Treatment depends on how severe the fracture is and whether the bones are out of position. Mild fractures may heal with nonsurgical care, while more complex injuries often require surgery.
Treatment options may include:
- Splints or casts
- Walking boots
- Pain medications
- Surgery with plates and screws
- Physical therapy
- Crutches or limited weight-bearing during healing
Recovery can take several months. Physical therapy is often important to improve ankle strength, flexibility, and movement after healing begins.
Because pilon fractures affect the ankle joint, some people may develop long-term stiffness or arthritis even after treatment.
