OBJECTIVETo investigate the clinical results of distal tibia fractures accompanying with anterior soft tissue injury by posteromedial approach.

METHODSFrom August 2008 to August 2010,31 patients (21 males and 10 females, ranged in age from 24 to 68 years with an average of 46 years) with distal tibia fractures accompanying with anterior soft tissue injury were treated with open reduction and internal fixation through posteromedial approach. Of the 31 cases, 14 cases were open fractures (including 5 cases Gustilo-Anderson type I, 5 type II, 2 type III A, and 2 type III B) and 17 cases were closed fractures (including 3 cases Tcherne-Oestern type I, 12 type II, 2 type III). According to typing of AO, type 43A were in 26 cases and type 43C1 were in 5 cases. Operation time, intraoperative blood loss, fracture healing time, AOFAS ankle score, and complications were recorded to evaluate clinical effects.

RESULTSAll the patients were followed up from 12 to 36 months with an average of 21 months. The mean operation time was 70 min (ranged, 40 to 110 min) and the mean blood loss was 100 ml (ranged, 50 to 200 ml). Average healing time for closed fractures was 13 weeks (ranged, 10 to 18 weeks), while open fractures was 19 weeks (ranged, 15 to 29 weeks). Cross-foot of 40 occurred in 1 case and pes valgus of 30 in 1 case at final follow-up; and AOFAS ankle scores were from 69 to 100 with an average of 88.4 +/- 9.7. Of them, 10 cases obtained excellent results, 17 good, 4 fair.

CONCLUSIONPostermedial approach is an effective method for distal tibia fractures especially accompanying with local soft tissue injury or bad skin condition.