Pilon fractures vary. The tibia may break in one place or shatter into multiple pieces.
The severity of the injury depends on several factors, including:
The number of fractures
The amount and size of the broken bone fragments
The amount each piece is out of place (displaced)—In some cases, the broken ends of bones line up almost correctly; in more severe fractures, there may be a large gap between the broken pieces, or the fragments may overlap each other.
The injury to the surrounding soft tissues, such as muscle, tendons, and skin
If the bone breaks in such a way that bone fragments stick out through the skin or a wound penetrates down to the broken bone, the fracture is called an "open" or compound fracture. This type of fracture is particularly serious because, once the skin is broken, infection can occur in both the wound and the bone. Urgent treatment is required to prevent infection.