Document Type : Original Article

Authors

1 Associate Professor, Department of orthopedics, Taleghani Hospital Research Development committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

2 Assistant Professor, Department of orthopedics, Taleghani Hospital Research Development committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 Assistant Professor, Department of Orthopedics, Shohada Tajrish Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 Professor, Orthopedic Surgery Department, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Shahid Beheshti University of medical sciences, Tehran, Iran.

10.30491/tm.2023.307157.1377

Abstract

Background: The study aimed to compare a new posteromedial approach with a conventional anteromedial approach to treat extra-articular distal tibia fracture.
Method: This prospective, randomized clinical trial study was approved by institution’s internal review board, and clinical trial registry database.  Thirty-two patients underwent distal tibia fracture surgery. The patients were divided into two groups (anteromedial: n=17 and posteromedial: n=15) and followed for one year. Approaches were compared regarding their efficacy in union time, American Orthopedics Foot and Ankle Society (AOFAS) score, and complications.
Results: AOFAS score was 87.3 ± 3.1 and 88.5 ± 2.8 in anteromedial and posteromedial groups, respectively. And there was no statistically significant (P-value = 0.282). The union time was 6.1 ± 3.8 months and 6.4 ± 3.1 months in groups, which was not statistically significant (P-value = 0.807). The prevalence of non-union and delayed union was not significantly different between the two groups (p-value = 0.99). No significant difference between groups was seen in adverse effects and complications related to skin incision.
Conclusion: Posteromedial approach is a safe and feasible alternative surgery method in distal tibia extra-articular fractures. This approach can provide better vascularity and prevent soft tissue complications in skin flaps.

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