Executive Editor: Peter Trafton, Michael Baumgaertner

Authors: Martin Hessmann, Sean Nork, Christoph Sommer, Bruce Twaddle

Distal tibia

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Glossary

Anterolateral approach

The anterolateral approach is useful in the majority of complete articular pilon fractures, anterior and anterolateral partial articular pilon fractures, and some extraarticular distal tibia fractures.

Anteromedial approach

This approach is used for open reduction and internal fixation of the articular part of the tibia. It facilitates accurate articular reduction combined with submuscular and subcutaneous plate applications.

Medial approach

A direct medial approach can be used for vertical medial split fractures with associated articular impaction.

Minimally invasive approach

This MIO approach is used for extraarticular fractures, or for simple, minimally displaced, complete articular fractures.

Posterolateral approach

This approach lends itself to fracture patterns that are primarily displaced fractures of the posterior tibia with little or no involvement of the anterior tibial surface. It allows fixation of both the fibula and tibia through the same incision.

Posteromedial approach

The posteromedial exposure allows direct reduction of posterior and medial fracture fragments.

Nailing approach

The nail entry point is on the anterior edge of the tibial plateau, missing the menisci, and centered over the medullary canal on the AP view.

Safe zones

When inserting Schanz screws in the distal zone consider the position of the anterior tibial artery and vein. Percutaneous insertion of Schanz screws or pins in the distal tibia is dangerous.

v2.0 2018-11-12