A pilon fracture is a type of break that occurs at the bottom of the tibia shinbone and involves the weight bearing surface of the ankle joint with this type of injury the other bone in the lower leg the fibula is frequently broken as well. Pilon is a french term used to describe a fracture of the distal tibia usually characterized by high energy traits including dissociation of the articular surface from the tibia shaft destot coined the term pilon as he thought that the distal tibial metaphysis resembled a pharmacists pestle o. Complete fractures of the tibial pilon are rare and their treatment difficult the pathophysiology includes three groups a high energy trauma motor vehicle injuries with severe articular and soft tissue lesions b rotation trauma skiing accidents with modest articular and soft tissue damage and c low energy trauma in elderly people. Fractures of the tibial pilon are difficult to manage because of their severity they are the product of high energy compression forces and too frequently result in comminution and impaction of the weight bearing surface of the distal tibia