Tibial Plafond/Pilon Fractures

Tibial Plafond/Pilon Fractures


  • Average patient age is 35-40 years
  • More common in males than females

Mechanism of Injury

  • High energy axial load (motor vehicle accidents, falls from height)

Tibial Plafond Fractures Post Operative Instructions


  • You will have a plaster cast on your ankle for 6 weeks following surgery
  • At 2 weeks (wounds permitting) a below knee cast will be applied.
  • At 6 weeks an aircast will be applied and you can begin weightbearing
  • At 12 weeks you can wean from the aircast to a regular shoe


  • The surgical incision has been closed with sutures
  • Do not get the cast or wound wet for the first two weeks. When showering place a bag over the cast and secure with tape to your leg to avoid the cast and wound getting wet
  • Stitches will be removed at your 2 week appointment
  • After the stitches are removed, you may begin to shower after 2-3 days
  • Do not immerse the foot in water (bath, hot tub, pool) for 4 weeks
  • Do not apply any lotions or creams on the wound for 6 weeks

Weight Bearing:

  • You will be non-weight bearing for the first 12 weeks
  • You will use a mobility device to offload your foot (crutches, walker, stirrup cast)
  • After 12 weeks you may begin fully walking on the foot in an foot.


  • You will be given a prescription for pain medication and Aspirin (blood thinner)
  • Pain medication should be used regularly for the first 24-48 hours, when required for the first 1 to 2 weeks, followed by Regular Tylenol
  • Aspirin should be taken for 14 days (unless you have an allergy to aspirin)


  • For right foot surgery you are not permitted to drive until you have completely weaned off the aircast
  • For left foot surgery, please contact your insurance company to see if you are permitted to drive
  • Driving is not permitted while on narcotics


  • Two weeks off work is recommended for initial recovery
  • If you are able to get to work safely, and will be seated for the majority of the day, you may return to work a couple days after surgery. This is assuming you are not taking narcotic pain mediation.
  • From 12-16 weeks sedentary duties is recommended
  • By 16 weeks you can gradually return to full duties
  • If your job is physically demanding, return to full duties is usually possible around 6 months weeks post operatively

Follow Up:

  • You will have your first appointment 2 weeks after surgery in the Fracture Clinic
  • Your next appointments will be at 6 weeks, 3 months then 6 months post operatively


  • It is normal to experience mild to moderate pain, numbness, or tingling for the first 2 weeks following surgery
  • Please come to the emergency department if you are suffering from severe pain
  • You will get back to most of your activities by 3-6 months
  • Swelling often remains for 6-12 months
  • Residual stiffness is a normal consequence of ankle fracture