What is the Tibial Plafond?
The tibial plafond is the distal articular surface of the tibia that forms the weight-bearing roof of the ankle joint. 1
Anatomical Definition
- The tibial plafond represents the bottom articular surface of the tibia where it articulates with the talus to form the ankle joint 2, 1
- This structure is also commonly referred to as the "pilon" in orthopedic terminology 1, 3
- The plafond includes both the horizontal articular surface and extends to include the medial malleolus 4
Clinical Significance
Anatomical Characteristics
- The tibial plafond demonstrates high bilateral symmetry between left and right sides, with median differences of only 0.57 mm for the entire plafond and 0.53 mm for the articulating surface specifically 4
- The areas with greatest anatomical variation are the medial malleoli and the anterior tubercle of the tibial plafond 4
Injury Patterns
- Fractures of the tibial plafond (pilon fractures) typically result from high-energy mechanisms and are associated with significant morbidity 1, 3
- These injuries can involve the articular surface and may be missed or misdiagnosed due to distracting injuries and variable clinical presentations 1
- Osteochondral injuries may involve the tibial plafond, though this occurs less commonly than talar dome involvement 5
Imaging Considerations
- Standard anteroposterior radiographs primarily characterize the anterior portion of the tibial plafond well, but provide poor assessment of the posterior portion of the joint 6
- This imaging limitation can mislead surgeons during intraoperative assessment, potentially accepting inadequate reduction when posterior incongruity still exists 6
- The bilateral symmetry of the plafond allows the contralateral uninjured side to serve as a template for preoperative surgical planning in fracture cases 4