What is a pilon fracture?

So we discussed the simple ankle fractures and now we just talk about a different form of ankle fracture which we see quite a lot of here at St. Mary's and this is called a pilon fracture. It's similar to this sort of device where the bone actually smacks into the bottom end of the tibia causing it to shatter. So here if you imagine the bottom end of the foot the talus has been driven up into the tibia and caused it to smash into many different fragments and these are usually high-energy injuries where the patients involved in a road traffic accident or they've fallen from height and they result in various different patterns this is a reasonably simple one where there's four fragments, here there's different fragments you can see the 3D model all showing the different type of fractures that you can get in a pilon and they are treated similarly to the ankle fractures but we use more metal work to put all the fractures back together. All ankle fractures especially with pylons do increase the risk of a condition that we call post traumatic arthritis and I want your patients to be wary of that because when you have a simple injury and everything looks wonderful on the x-ray but then the patient still goes on and develops arthritis in the ankle joint it's usually from the time of the injury and that heavy impact that they sustain with one bone smacking into another often causes damage to the cartilage inside the joint and then later on they develop arthritis and this can then cause further pain and although the fracture is healed by that stage they start developing arthritic changes a couple of years after the injury which may need further management.