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November 02, 2019
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Posterolateral plating may be a viable treatment for distal tibia fractures

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DENVER — Posterolateral plating is a viable alternative treatment for distal tibia fractures, according to results presented at the Orthopaedic Trauma Association Annual Meeting.

Michael Schloss, BA, and colleagues conducted a retrospective case series of 74 patients with a mean age of 48 years. Most patients within this case series had pilon fractures and about half of the patients had open fractures.

“The objective of our paper was the assess the outcomes and safety of posterolateral plating of distal tibia fractures,” Schloss said during his presentation. “Our hypothesis was that using the posterolateral approach for select fractures would result in an acceptable complication profile.”

According to the abstract, patients were treated with a precontoured T-shaped locking compression plate using the posterolateral approach during a 10-year period.

The risk of reoperation in this posterolateral plate case series was 15%, the risk of nonunion was 5% and the risk of surgical site infection was 4%. One patient had to undergo unplanned reoperation for nonunion after losing alignment and one patient had a case of wound dehiscence in the posterolateral approach. There were no neurovascular issues found in patients in the case series.

Results presented at the meeting showed use of the posterolateral approach with distal tibia fractures led to reasonable outcomes, even with a high proportion of open fractures in the cohort.

“The posterolateral approach in definitive fixation of the distal tibia and pilon has an acceptable and reasonable risk of complications,” Schloss said. “This is a viable treatment option for higher risk fractures of the distal tibia, particularly if you have interior soft tissue concerns.” by Erin T. Welsh

 

Reference:

Schloss M, et al. Paper 84. Presented at: Orthopaedic Trauma Association; Sept. 26-28, 2019; Denver.

 

Disclosure: Schloss reports he has no relevant financial disclosures.