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Classification of Pilon Fractures

- Classification: (Ruedi-Allgower):
    - type I: pilon Frx
         - malleolar frx w/ significant axial load at time of injury & therefore large posterior plafond fragments;
    - type II: pilon Frx
         - spiral extension frx;
    - type III: pilon Frx
         - type III frxs are central compression injuries w/ impaction of talus into distal tibia w/ or w/o concomitant fibular frx;
         - subdivided as discussed into subgroups A-C depending on degree of displacement of articular surface & presence or
                   absence of comminution and/or impaction;
    - type A:
         - minimal or no anterior tibial cortical communition, > 2 large tibial articular fragments, and usually a fibular fracture of transverse
                  or short oblique at the level of the plafond (or ankle joint);
    - type B:
         - results from severe axial compression force, causing distal tibial bony impaction and comminution

OA for the Study of Internal Fixation and AOrthopaedic Trauma Association Classification

Type A: Distal tibial metaphyseal injuries without intra-articular extension
      A1: Simple
      A2: Comminuted
      A3: Severely comminuted

Type B: Partial articular fractures     
      B1: Pure split
      B2: Split with depression
      B3: Depression with multiple fragments

Type C: Fracture involves the entire joint surface 
      C1: Simple split in the articular surface and the metaphysis
      C2: Articular split that is simple with a metaphysis split that is multifragmentary
      C3: Fracture with multiple fragments of the articular surface and the metaphysis

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