Classification of Pilon Fractures

- Classification: (Ruedi-Allgower):
    - type I: pilon Frx
         - malleolar frx w/ significant axial load at time of injury & therefore large posterior plafond fragments;
    - type II: pilon Frx
         - spiral extension frx;
    - type III: pilon Frx
         - type III frxs are central compression injuries w/ impaction of talus into distal tibia w/ or w/o concomitant fibular frx;
         - subdivided as discussed into subgroups A-C depending on degree of displacement of articular surface & presence or
                   absence of comminution and/or impaction;
    - type A:
         - minimal or no anterior tibial cortical communition, > 2 large tibial articular fragments, and usually a fibular fracture of transverse
                  or short oblique at the level of the plafond (or ankle joint);
    - type B:
         - results from severe axial compression force, causing distal tibial bony impaction and comminution

OA for the Study of Internal Fixation and AOrthopaedic Trauma Association Classification

Type A: Distal tibial metaphyseal injuries without intra-articular extension
      A1: Simple
      A2: Comminuted
      A3: Severely comminuted

Type B: Partial articular fractures     
      B1: Pure split
      B2: Split with depression
      B3: Depression with multiple fragments

Type C: Fracture involves the entire joint surface 
      C1: Simple split in the articular surface and the metaphysis
      C2: Articular split that is simple with a metaphysis split that is multifragmentary
      C3: Fracture with multiple fragments of the articular surface and the metaphysis

Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Friday, February 27, 2015 10:32 am