Pilon fractures: a severe break at the ankle joint after a crash
How an orthopedic trauma surgeon approaches a pilon fracture
A pilon fracture is a break in the lower end of the shinbone, where it forms the ankle joint. In a major crash, the joint surface may break into many pieces. The skin and soft tissue around the ankle can swell badly too. [1]
A surgeon may first hold the leg steady with a temporary frame outside the body. The bone can be repaired later, once the swelling goes down. Doing the work in stages is part of protecting the soft tissue. [1]
Know which stage you're in
Ask if your current frame or splint is temporary. Find out what needs to get better before the next operation. Ask if you have an open wound, damaged skin or a broken fibula, the thinner bone in the lower leg. [1]
If you had plates and screws put in, ask whether the joint surface was restored. Find out what your later scans will check. Write down every planned procedure and clinic date. [1]
Protect the ankle through a long recovery
Find out whether you can put any weight on the leg. Before you go home, practice getting in and out of bed or a chair safely, plus using stairs. Ask how to raise the leg, care for the wound or pin sites and check your toes. [1]
Start moving your ankle only when your surgeon says you can. While your walking is limited, a physical therapist can help you keep strength and balance in the rest of your body. [1]
Call about skin or blood flow changes
Get urgent care for a cold or pale foot or pain that climbs fast. The same goes for toes you can no longer move or new, severe numbness. Call the surgical team about a fever, spreading redness, drainage or skin under the splint that looks at risk. [1]
Once you’ve healed, tell your team about stiffness or pain that won’t go away. Don’t assume every limit is permanent. [1]
Questions about your ankle repair
- If my repair is being done in stages, why?
- What are my rules for putting weight on the leg and caring for the wound?
- When will my ankle motion and scans be checked again?
Keep your repair details in writing
Keep a written list with your current repair stage and your next appointment. Include the exact number to call about changes in your skin or pin sites. [1]
Sources and further reading
This is for general education only and reflects an orthopedic trauma view. Pilon fractures differ from person to person. Follow the specific instructions you were given for your wound, frame, ankle movement and weight bearing.
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