Dual Plating for Posterior Pilon Fractures Case Study

Jeffrey D. Seybold, MD. A 38-year-old female who sustained a left ankle fracture with significant posterior malleolar fracture fragments was treated successfully with the Acumed Ankle Plating System 3. Patient History: The patient is a 38-year-old female with a history of hypothyroidism and limited daily nicotine use who slipped on a patch of ice and fell, twisting her left ankle. The patient was brought to an orthopaedic urgent care where radiographs demonstrated minimally displaced posterior pilon and distal fibula fractures. The patient was placed into a short-leg splint and a CT scan was ordered. She presented to clinic for definitive evaluation and treatment 4 days following her injury, where examination demonstrated moderate soft tissue edema around the ankle, but no fracture blisters or significant deformity. A CT scan confirmed the presence of a posterior pilon fracture with mild displacement of the posterolateral fragment, a mildly displaced distal fibula fracture without anterior syndesmosis gapping, and extension of the posteromedial fracture line to the medial malleolus without a separate medial malleolus fracture. Operative intervention was recommended and the patient proceeded to undergo ORIF of the posterior pilon and distal fibula fractures a few days following her clinic visit.