Tibial pilon fractures account for 1% to 10% of all lower extremity injuries. The difficulty in managing these injuries is primarily due to the precarious vasculature around the ankle. Medial plating using LCP on the subcutaneous medial border of distal tibia resulted in a significant rate of wound dehiscence and deep infection. Plating on the lateral surface of tibial plafond is a new entity and the anterolateral approach is gaining popularity for the fixation of tibial pilon fractures.
Materials and methods: In our study 20 cases with a minimum follow up of 4 months and maximum of 12 months with an average of 9 months was carried out. Anterolateral approach to ankle was used and anterolateral locking compression plates are placed through the interval between the anterior and lateral compartments of leg. All cases were assessed postoperatively using the Kaikkonen clinical ankle score and Teeny wiss radiological score.
Results: 20 fractures united with a mean duration of 16.9 weeks. In our study we had excellent functional outcome in about 20% of cases, good functional outcome in 60% of cases fair and poor outcome 20% of cases each based on Kaikkonen Ankle Score. In our study the complication we met were 2 cases (10%) of wound dehiscence and superficial infection which healed by secondary intention. One patient had superficial peroneal nerve neurapraxia which improved gradually over time without any intervention. One patient had nonunion which required bone grafting later on for fracture healing.
Conclusion: Anterolateral approach with anterolateral plating in the distal tibia fractures is safe easy and effective and has excellent to good functional outcome in most of the fracture types.