Pilon fractures are fractures of the distal tibia articular surface. These fractures are caused by high energy mechanisms, such as motor vehicle accidents or high falls.

In cases were articular damage is serious, the reconstruction is of high technical difficulty, thus these fracture types present an bad prognosis and are prone to complications.

In the illustrated case, 5 big fragments and multiple small, non-viable, articular fragments are present.

Careful study and planning of the fracture are cornerstone for the success. In this case a 2 incision approach enabled to fill the bone defect with substitute, obtaining an optimal reduction, mandatory for good functional recovery

BONE TUMORS

Other lesions that may affect this region, although rare, are bone tumors. This case represents a pathological fracture, with varus displacement.

A marginal treatment of the cyst, with intra-lesional filling with PMMA, was performed. Attention to the correction of the angular displacement to avoid medial joint overloading and progression to degenerative osteoarthritis is needed.