What are Pilon Fractures?

A pilon fracture is a relatively uncommon bone break near your ankle at the bottom of your tibia, the larger of your lower leg’s two bones, or your shinbone. The other bone in your lower leg, the fibula, is frequently damaged in pilon fractures. High-impact events, such as a car collision or falling from a great height, are the most common causes of pilon fractures.

There are numerous varieties of pilon fractures, each with its classification system. Healthcare providers classify pilon fractures as Type I, Type II, and Type III using the Ruedi-Allgower classification system. Your healthcare provider may use terms like closed or open, complete, displaced, comminuted, impacted, or spiral fracture to characterise your pilon fracture.


The most common cause of pilon fractures is when your talus, or weight-bearing bone in your ankle, is forced into your lower leg bones, the tibia and fibula, with such force that your leg bones shatter at the ankle joint. High-impact events like a vehicle accident, falling from a great height, skiing accidents, and bone weakening disorders like osteoporosis, where a pilon fracture can occur from a low-impact event like a slight fall, can cause pilon fractures.


Intense pain in your lower leg and ankle, bruising, swelling, or skin blisters around your lower leg and ankle, inability to put weight on your injured leg, or an ankle that appears crooked or deformed are all signs and symptoms of a pilon fracture. A wound may also be seen when the fracture is compound or open. 


The number of fracture fragments, the pattern or kind of fracture, the degree of bone displacement, and other factors influence how a pilon fracture is treated. In very few cases when the pilon fracture is not displaced, you may not need surgery, and your bones are still positioned appropriately.

You’ll almost certainly need surgery if your pilon fracture is displaced and the bones aren’t positioned correctly. However, the doctor may postpone surgery until the swelling around your ankle has subsided and you are healthy enough to undergo surgery, depending on the severity of your fracture and whether you have other injuries. In addition, it will reduce the chance of infection.

Book a consultation with our expert Dr Anuj Chawla for more information about Pilon Fractures or other ankle or foot-related issues.