Differences in Pilon Fractures According to Ipsilateral Fibular Injury Patterns: A Clinical Computed Tomography-Based...

Area of Science:

• Orthopedic surgery
• Radiology
• Trauma management

Background:

• Accurate preoperative assessment of pilon fracture morphology is critical for surgical planning.
• Fibular injury patterns significantly influence pilon fracture characteristics.
• Understanding these correlations can optimize fixation strategies.

Purpose of the Study:

• To investigate the relationship between fibular fracture patterns and pilon fracture morphologies.
• To identify clinical implications of these correlations for surgical treatment.

Main Methods:

• Retrospective analysis of 96 pilon fracture CT scans.
• Classification of fibular injuries into intact, simple, and multifragment fractures.
• Fracture mapping using a plafond template and a 6x6 grid to analyze principal fracture lines and comminution zones.

Main Results:

• The anterolateral quadrant was the most common location for the thickest comminution zone.
• Multifragment fibular fractures showed comminution zones located more laterally compared to other groups.
• Lateral fracture line exits in multifragment fractures were concentrated near the fibular incisura.

Conclusions:

• Complex fibular fractures in pilon injuries are associated with a valgus position.
• Pilon articular fracture patterns vary based on coronal angulation and fibular injury type.
• These findings should guide operative approach and plate fixation strategies.