Findings
- Acute distal tibial fracture with extensive comminution and impaction of the tibial plafond with mild medial subluxation, varus angulation, and dorsiflexion at the tibiotalar joint
- Posterior rotation of the posterior malleolar fracture fragment which involves about 30% of the AP width of the tibial plafond
- A vertically-oriented medial malleolar fracture fragment maintains its relationship with the talus
- Acute transverse distal fibular fracture approximately 1 cm proximal to the tibiotalar joint with apex lateral angulation
- Irregularity and slight flattening of the talar dome
- Soft tissue swelling about the ankle
Diagnosis
Pilon fracture
Sample Report
Acute pilon fracture with extensive comminution and impaction of the tibial plafond with mild medial subluxation, varus angulation, and dorsiflexion at the tibiotalar joint. Posterior rotation of the posterior malleolar fracture fragment which involves about 30% of the AP width of the tibial plafond. A vertically-oriented medial malleolar fracture fragment maintains its relationship with the talus. Recommend CT for further fracture characterization and to assess for associated soft tissue injuries.
Acute transverse distal fibular fracture approximately 1 cm proximal to the tibiotalar joint with apex lateral angulation.
Irregularity and slight flattening of the talar dome concerning for impaction fracture.
Soft tissue swelling about the ankle.
Discussion