Causes / typical injury mechanism: A pilon fracture (also known as a tibial plafond fracture) is a leg injury involving a fracture of the distal segments of the tibia as well as the fibula in many cases. High-energy axial loads from trauma, such as in motor vehicle accidents or falls from height, can cause the injury. Specifically, the fracture is generally caused by the talus bone striking the tibia with excessive force upon impact.

Classic history and presentation: The classic history includes a patient with recent trauma who presents with severe pain and swelling of the lower leg and ankle joint. There is often visible deformity of the joint. There may be signs of soft tissue injury, other musculoskeletal injuries, or neurovascular complications.

Prevalence: Pilon fractures account for about 5%-7% of tibial fractures overall. The incidence has increased as the survival rate of motor vehicle accidents has increased due to advanced safety features.

• Age – The average patient is roughly 35-40 years of age.
• Sex / gender – It presents more frequently in men than in women.