The Efficacy of the Posteromedial Approach to the Distal Tibia in TriMalleolar Fractures

الملخص

Background: Tri-malleolar injuries are complicated injuries, which entail a combination of medial, lateral (fibular), and posterior malleoli injury. In their treatment, they need operative fixation to provide the restoration of congruity within the articular structures and help to prevent post-traumatic osteoarthritis. Posterior malleolus The posteromedial approach to the distal tibia exposes the posterior malleolus directly with minimum disruption of adjacent soft-tissue. Objective: The aim was to compare the clinical and functional outcome of tri-malleolar fracture treated surgically through posteromedial approach to the distal tibia. Methods: A retrospective study was carried out with 17 patients who have been operated with the fixation during the period of January 2022 to December 2024. Some of the variables that were analysed were the length of the operation, period of follow-up, pre and post operative AOFAS ankle-hindfoot scores, VAS pain scores (rest, and ambulation), age of patient, and sex. Paired t-tests and Pearson correlation coefficients were used with Statistical IBM SPSS v.26. Results: the average operating time recorded was 64.1/6.8 minutes with a follow up being 12.8/2.2 months. The AOFAS scores were significantly better during the postoperative period measured at 81.43 ± 4.7 compared with 38.53 during the preoperative period, which is an improvement of 42.92 with a standard deviation of 5.3. The rest and walking VAS scores were 0.35 and 0.94 respectively. No significant complications were noted. Conclusion: The posteromedial method of the distal tibia is a safe, effective, and reproducible method of treating tri-malleolar fractures that provides remarkable functional outcome and has minimal postoperative pain. Download Full Text