OBJECTIVETibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages.

METHODSBetween July 2008 and June 2011, 12 patients were prospectively treated by this approach using 4.5 mm broad dynamic compression plates.

RESULTSThe time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks). Patients were followed up for at least 24 months (range, 24-48 months). At 1 year postoperatively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78). All patients were satisfied with their treatment outcomes.

CONCLUSIONDirect posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating.