title: The use of medial and lateral surgical approaches for the treatment of tibial plafond fractures.
abstract: There has been a sharp reduction in complications associated with tibial pilon fractures with the introduction of the two-step approach to treatment. However, there has yet to be any real reevaluation of the standard anterior approach used to expose and reduce these fractures. Now, with the ability to obtain computed tomographic (CT) scans after initial reduction, the fracture pattern of the tibia can be seen more clearly, suggesting that perhaps other surgical approaches may be better suited to visualize, reduce, and stabilize these injuries. At our institution, a two-incision approach using standard medial and lateral incisions, when appropriate to the fracture pattern, was found to allow improved visualization of the tibial articular surface and talus, ease of fixation placement with the new plate designs, and a low complication rate regarding soft-tissue issues when compared with published methods.
authors.affiliation: From the Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX.
authors.forename: Leo
authors.initials: L
authors.lastname: Chen
authors.forename: Kevin
authors.initials: K
authors.lastname: O'Shea
authors.forename: John S
authors.initials: JS
authors.lastname: Early
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D011183:Postoperative Complications; D011859:Radiography; D013530:Surgical Wound Infection / Q000188:drug therapy; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents