Extra-articular distal tibia fibula fracture managed with single posterolateral approach: a case report

Authors

  • Neetin P. Mahajan Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Prasanna Kumar G. S. Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Tushar C. Patil Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Kartik P. Pande Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India
  • Harish Pawar Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20211632

Keywords:

Distal tibia fracture, Extra-articular, Posterolateral approach, Plating

Abstract

Extra-articular distal tibia fractures involve distal tibia approximately 4 cm within tibia plafond with no articular extension. The proper preoperative care, planning and selection of surgical approach is very essential to prevent postoperative wound-related complications. We present a case of a 29 year female patient, presented with left ankle pain and swelling with a wound over the medial aspect of the ankle. X-ray of the left ankle showed extra-articular distal tibia fibula fracture with no neurovascular deficit. We managed both the fractures with open reduction and internal fixation using a single posterolateral approach. At present 1 year follow-up, the patient is having a good range of ankle motion with radiological union with no implant failure and wound-related complications. Extra-articular distal tibia fibula fracture fixation using single posterolateral approach is a viable alternative approach to medial or anterolateral approach in cases of medial or anterior soft tissue problems. It helps in getting a better functional outcome, early mobilisation with less wound-related complications.

References

Richard RD, Kubiak E, Horwitz DS. Techniques for the surgical treatment of distal tibia fractures. Orthopedic Clinics North Am. 2014;45(3):295-312.

Schloss MG, Ghulam Q, Hannan Z, O'Hara NN, Napora JK, McAlister IP, et al. Posterolateral plating is a safe alternative for the treatment of distal tibial fractures. Injury. 2020;51(7):1662-8.

Yamamoto N, Ogawa K, Terada C, Okazaki Y, Munetomo K, Noda T, et al. Minimally invasive plate osteosynthesis using posterolateral approach for distal tibial and tibial shaft fractures. Injury. 2016;47(8):1862-6.

Ronga M, Longo UG, Maffulli N. Minimally invasive locked plating of distal tibia fractures is safe and effective. Clinic Orthop Rel Res. 2010;468(4):975-82.

Kritsaneephaiboon A, Tangtrakulwanich B, Dissaneewate P. Minimally invasive plate osteosynthesis (MIPO) of distal tibial fracture using a posterolateral approach. Orthop Surg. 2015;14(3):139-45.

Tornetta P, Ricci W, Nork S, Collinge C, Steen B. The posterolateral approach to the tibia for displaced posterior malleolar injuries. J Orthop Trauma. 2011;25(2):123-6.

Gobezie RG, Ponce BA, Vrahas MS. Pilon fractures: Use of theposterolateral approach for orif. Operat Tech Orthop. 2003;13(2):113-9.

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Published

2021-04-26

Issue

Section

Case Reports