Background: Distal tibial and tibial shaft fractures with high energy trauma are often associated with complications of soft tissues injuries, especially in the anterior or medial aspect of the tibia. These fractures are some of the most problematic fractures for the reason of incision breakdown, infection, or skin necrosis, necessitating secondary operations. Evaluation of the soft tissues healing after using a posterolateral approach in fixation of distal tibia and fibula fractures was the aim of the study.
Patients and methods: This study was conducted on 20 patients with acute distal tibia and fibula fractures. The youngest patient was 18 years and the oldest was 60 years old. The mean age was 39.93 years .using a single posterolateral incision one cm behind fibula both tibial and fibular fractures were fixed.
Results: Post-operative radiographs presented an anatomical reduction associated with a congruent ankle joint in all cases. The mean operative time was 114±19.93 (range = 90-150 minutes).There were two patients (10%) with superficial wound infection, which were successfully treated with antibiotics. One patient (5%) suffered from skin edge necrosis at two sutures which improved by time. There was no presence of deep infection, wound breakdown or hardware exposure.
Conclusion: The posterolateral approach is a single incision approach that allows satisfactory wound healing with better cosmosis. Being unfamiliar to many orthopedic surgeons and its limitation in fractures with anterior comminutions, it is not considered a standard technique for distal tibia fractures and is not recommended to be used routinely. It may be a valuable alternative option when soft tissue envelope compromise is a major concern together with absence of anterior comminution. |
