PILON

Pilon is a term used in human anatomy to describe the distal portion of the tibia that contributes to the ankle joint. The tibial plafond refers to the articular surface at the distal tibia that articulates with the talus, and the term pilon is commonly used in clinical contexts to designate this region and its injuries.

Pilon fractures are injuries to the distal tibial plafond that typically result from high-energy axial loading, such as motor vehicle crashes or falls from height. They are often associated with extensive soft-tissue damage and can involve the distal fibula. The fracture pattern is typically comminuted and may include impaction of the articular surface.

Because of soft-tissue injury, initial management aims to protect the skin and gradually restore alignment. This often involves temporary external fixation to stabilize the limb, followed by definitive fixation once swelling subsides. Surgical strategies focus on reconstructing the articular surface and maintaining or restoring ankle joint congruity.

Outcomes depend on fracture type, articular reconstruction accuracy, and soft-tissue condition. Complications can include post-traumatic ankle arthritis, malunion, nonunion, wound complications, and infection. Long-term prognosis ranges from satisfactory function to significant arthritis, and some patients may require ankle fusion or ankle replacement later.