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: This study aimed to compare a new posteromedial approach with a conventional anteromedial approach to treat extra-articular distal tibia fractures.
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 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 difference (P-value = 0.282). The union time was 6.1 ± 3.8 months and 6.4 ± 3.1 months in the 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: the modified posteromedial approach is a safe and feasible alternative surgical method for distal tibia extra-articular fractures.

Keywords