The Pilon Map

There is a consistent fracture pattern underlying the majority of OTA/AO type 43C3 pilon fractures that could be defined as 3 main fragments: anterior, medial, and posterior. These result from a major fracture line extending from the fibular incisura and exiting anterior and posterior to the medial malleolus. The comminution commonly distinguishing pilon fractures occurs from secondary fracture lines through the apex of the plafond and in the anterolateral region. Knowledge of this constant pattern should influence surgical approaches and possibly implant design.