Ruedi-Allgower Classification (Pilon Fracture)
Classifies pilon (tibial plafond) fractures by articular displacement and comminution (Rüedi-Allgöwer I–III). High-energy injuries require staged fixation.
Score interpretation
→ Conservative: below-knee cast; NWB for 6-8 weeks; close follow-up. Open fracture or compartment syndrome at any type: emergency (open-fracture pathway; fasciotomy).
→ Adults with a displaced pilon fracture: definitive plan and initial surgery (temporary or definitive) within 24 hours of injury, transferring to an orthoplastic centre if this is not possible (NICE NG37). ORIF when swelling resolved (typically day 7-14); fibula first, then tibial plafond. Open fracture or compartment syndrome at any type: emergency (open-fracture pathway; fasciotomy).
→ Staged fixation: external fixation acutely (initial surgery within 24 hours of injury in adults, NICE NG37); definitive ORIF at 10-14 days when soft tissue allows. Open fracture or compartment syndrome at any type: emergency (open-fracture pathway; fasciotomy).
Interpretation bands for the Pilon / Ruedi-Allgower. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Hip Fracture Pathway · NICE CG124; BPT
- Cauda Equina Syndrome · Society of British Neurological Surgeons; BOA — Best Practice
- Knee Soft Tissue Injury (ACL / MCL / Meniscus) · BOA; Royal College of Surgeons
- Shoulder Dislocation · BOA; RCEM
- Scaphoid Fracture · BOA; BSSH
- Pelvic Fracture · BOA; ATLS; NICE NG39
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.