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Adolescent Pilon Fracture S82.209A 823.80

 

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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