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<p>Tibial pilon fractures are complex articular injuries that involve the weight-bearing surface of the distal tibia (tibial plafond). They typically result from high-energy axial loading, which drives the talus into the tibial plafond, leading to significant articular comminution and associated soft-tissue damage. While radiography represents the first-line investigation for tibial fractures, CT is indispensable for accurate diagnosis and surgical planning. CT provides detailed three-dimensional (3D) visualisation of fracture patterns, articular surface depression, and fragment orientation, which is essential for proper classification and formulating a treatment strategy. Management is challenging and often follows a staged protocol, beginning with temporary external fixation to allow soft-tissue recovery, followed by definitive open reduction and internal fixation. The primary treatment goal is the anatomical restoration of the articular surface. The quality of surgical reduction, as assessed on post-operative radiographs, is a critical prognostic factor for functional outcomes. The primary aim of this article was to provide a comprehensive and up-to-date review of tibial pilon fractures, encompassing their pathophysiology, relevant clinical anatomy, modern diagnostic imaging techniques, classification systems, principles of treatment, and associated complications.</p>

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Tibial pilon fractures: a radiological review of imaging patterns and classification

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月7日

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  • Consolato Gullì,
  • Emanuele Ferravante,
  • Mario Di Diego,
  • Giuseppe Ferrara,
  • Daniele Perla,
  • Antonio Leone

摘要

Tibial pilon fractures are complex articular injuries that involve the weight-bearing surface of the distal tibia (tibial plafond). They typically result from high-energy axial loading, which drives the talus into the tibial plafond, leading to significant articular comminution and associated soft-tissue damage. While radiography represents the first-line investigation for tibial fractures, CT is indispensable for accurate diagnosis and surgical planning. CT provides detailed three-dimensional (3D) visualisation of fracture patterns, articular surface depression, and fragment orientation, which is essential for proper classification and formulating a treatment strategy. Management is challenging and often follows a staged protocol, beginning with temporary external fixation to allow soft-tissue recovery, followed by definitive open reduction and internal fixation. The primary treatment goal is the anatomical restoration of the articular surface. The quality of surgical reduction, as assessed on post-operative radiographs, is a critical prognostic factor for functional outcomes. The primary aim of this article was to provide a comprehensive and up-to-date review of tibial pilon fractures, encompassing their pathophysiology, relevant clinical anatomy, modern diagnostic imaging techniques, classification systems, principles of treatment, and associated complications.