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synonyms:Tibial Plafond Fracture, distal tibia fracture
Adolescent Pilon Fx ICD-10
Adolescent Pilon Fx ICD-9
- 823.80(closed fracture of unspecified part of tibia)
- 823.81(closed fracture lower leg NOS; fibula alone)
- 823.82 (closed fracture lower leg NOS; fibula with tibia)
- 823.90(open fracture of unspecified part of tibia)
- 823.91(open fracture of unspecified part fibula alone)
- 823.92 (Unspecified part, open, fibula with tibia)
Adolescent Pilon Fx Etiology / Epidemiology / Natural History
- Definition: any fracture of the tibial plafond with articular and physeal involvement, variable talar and fibular involvement, variable comminution, and >5mm displacement. (Letts M, JPO 2001;21:2026).
Adolescent Pilon Fx Anatomy
Adolescent Pilon Fx Clinical Evaluation
- Pain and deformity in the ankle, degree dependent on fracture severity.
- Evaluate skin integrity, swelling, and neurovascular status of the leg/foot.
Adolescent Pilon Fx Xray / Diagnositc Tests
- A/P, lateral and mortise views of the ankle. Appears like a Tillaux fracture on A/P and mortise views.
- CT demonstrates that fracture line does not extend through the anterior cortex.
- MRI generally not indicated although can provide information on ligamentous and physeal injury. (Lohman M, Skeletal Tadiol 2001;30:504).
Adolescent Pilon Fx Classification / Treatment
- Letts Classification (Letts M, JPO 2001;21:2026).
- Type I: minimal comminution, no physeal displacement
- Type II: marked comminution, <5mm physeal displacement
- Type III: marked comminution, >5mm physeal displacement
Adolescent Pilon Fx Associated Injuries / Differential Diagnosis
- Triplane Ankle Fracture
- Juvenile Tillaux Ankle Fracture
- Pediatric Distal Tibial Fracture
- Incisural Ankle Fracture
Adolescent Pilon Fx Complications
- Delayed union, nonunion
- Malunion
- Growth arrest
- Arthritis
- Osteonecrosis of the distal tibial epiphysis
- Compartment syndrome
Adolescent Pilon Fx Follow-up Care
Adolescent Pilon Fx Review References
- Rockwood and Wikins's Fractures in Children 6th ed, 2006
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