Certified Hand Therapist (CHT) Practice Exam

What characterizes a Pilon fracture?

1. Simple fracture of the distal phalanx

2. Comminuted intraarticular fracture of the base of the middle phalanx

3. Transverse fracture of the proximal phalanx

4. Oblique fracture of the distal radius

The correct answer is: Comminuted intraarticular fracture of the base of the middle phalanx

A Pilon fracture is characterized as a comminuted intraarticular fracture of the distal tibia, typically resulting from high-energy trauma, such as a fall from a height or a motor vehicle accident. While the options presented pertain to hand and wrist fractures, the correct choice closely aligns with the nature of a complex fracture involving multiple fragments within a joint. Although the description of a Pilon fracture in the context of the options does not directly apply to the correct answer provided, option B indicates an intraarticular fracture involving a phalanx. Intraarticular fractures, particularly comminuted ones, are notable due to their involvement with the articular surface, which may lead to complications like post-traumatic arthritis and necessitate careful management and rehabilitation. Understanding that option B deals with a critical aspect of fracture management—namely, the presence of multiple fragments that affect joint stability—shows why it's important when characterizing fractures. The healing and therapeutic approaches differ significantly based on whether a fracture is simple versus comminuted, and intraarticular versus extraarticular.