Surgery is commonly recommended for unstable fractures in which the bones are out of place. This will offer protection while your ankle continues to heal. After 6 weeks, your doctor may replace your cast with a removable brace. During this time, your doctor may recommend that you use crutches or a walker. You will most likely be unable to bear weight on your ankle for up to 12 weeks after your injury. During this time, you will need to return regularly for follow-up X-rays to make sure your ankle remains stable. Your doctor will closely monitor the healing of your fracture. For this reason, as the swelling in your ankle decreases, you may need frequent cast changes. To provide effective support, your cast must correctly fit your ankle. Once the swelling goes down, they will replace the splint with a short leg cast. In most cases, your doctor will first apply a splint to hold your ankle in place. It may also be recommended for patients who are unable to walk or patients with very serious medical problems who may not be able to tolerate surgery. Nonsurgical treatment may be recommended for stable fractures in which the pieces of bone are not displaced or are minimally displaced. Whether or not your doctor recommends surgery often depends on how out of place (displaced) the fractured pieces of bone are. Many pilon fractures require surgery but, rarely, some stable fractures can be treated nonsurgically. Your doctor may order a CT scan right away, or may wait until later in your treatment - after an external fixator is applied. A CT scan will also help your doctor plan your treatment. A CT scan can provide valuable information about the severity of the fracture by helping your doctor see the fracture lines more clearly. An x-ray can show if there is an injury to your bones or if the joints in your ankle are out of place.Ĭomputerized tomography (CT) scans. X-rays of the leg, ankle, and foot are commonly done to evaluate a pilon fracture. X-rays provide images of dense structures, such as bone. Information from imaging studies will help your doctor decide whether surgery is required and will be important for surgical planning. It is important to tell you doctor if you have pain in other parts of your body. Determine whether you have sustained any other injuries by examining the rest of your body.The amount of swelling will determine if and when surgery can be done. Check for swelling in your foot and ankle.Check your pulse at key points of the foot to be sure that there is a good blood supply to your foot and ankle.In some cases, nerves may be injured at the same time that the bone is broken. Check to see if you can move your toes and feel things throughout your foot.Examine your lower leg and ankle, looking for cuts from the injury and gently pushing on different areas to see if it hurts. Physical ExaminationĪfter discussing your symptoms and medical history, your doctor will perform a careful examination. If their injuries cause significant blood loss, it could lead to shock - a life-threatening condition that can result in organ failure. These patients may also have additional injuries to the head, chest, abdomen, or legs. Patients with high-energy fractures will almost always go to an urgent care center or emergency room for initial treatment because of the severity of their symptoms. Because of the energy required to cause a pilon fracture, patients may have other injuries that require treatment as well. In most cases, surgery is needed to restore the damaged bone to its normal position. In many pilon fractures, the bone may be crushed or split into several pieces due to the high-energy impact that caused the injury. Pilon is the French word for "pestle" - an instrument used for crushing or pounding. Pilon fractures are often severe injuries that can permanently affect the ankle joint. A pilon fracture typically occurs as the result of a high-energy event, such as a car collision or fall from a height. With this type of injury, the other bone in the lower leg, the fibula, is frequently broken as well. To find in-depth information on ankle fractures, please read Ankle Fractures (Broken Ankle).Ī pilon fracture is a type of break that occurs at the bottom of the tibia (shinbone) and involves the weight-bearing surface of the ankle joint. This article addresses pilon fractures-a specific type of fracture that occurs in the lower leg near the ankle.
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