Abstract
ObjectiveThis study aimed to investigate the feasibility of single incision for plating for the treatment of distal tibia and fibula fractures by a gross anatomic study.MethodsThe anatomical structures of the anterolateral lower legs were identified. The lower leg length was measured from the top of fibular head to the tip of lateral malleolus. The distances between the extensor digitorum longus and anterior border of distal thirds of the tibia as well as the fibula were also measured. Additionally, their mutual relationships to the surrounding anatomical structures were described.ResultsThe distances from the proximal, middle, and distal thirds of the tibia to the extensor digitorum longus were 2.96 ± 0.46, 1.85 ± 0.25, and 2.15 ± 0.30 cm, respectively; the distances from the proximal, middle, and distal thirds of the fibula to the extensor digitorum longus were 1.82 ± 0.28, 2.09 ± 0.31, and 2.30 ± 0.27 cm, respectively. The results indicated that the safe gap from the distal tibia to extensor digitorum longus (EDL) was 1.6–3.4 cm and from the EDL to fibula was 1.5–2.6 cm. In addition, the average number of vascular pedicle in tibialis anterior, extensor hallucis longus, extensor digitorum longus, peroneus longus, and peroneus brevis was 2–3. Injuries generated by retracting medially and laterally in vascular pedicle could hardly affect the distal muscles.ConclusionsTherefore, we suggest that it is feasible to plate fractures of both the distal tibia and fibula through one anterolateral incision.
Highlights
Fractures of the distal third of the tibia and fibula are relatively common fractures of long bones
Traditional open reduction and internal fixation for the treatment of fractures of the distal third of the tibia and fibula is usually accomplished via the double-incision approach, which may contribute to severe soft tissue devitalization, skin sloughing, and infection complication [5,6,7,10]
The results indicated that the safe gap from the distal tibia to extensor digitorum longus (EDL) was 1.6–3.4 cm and from the EDL to fibula was 1.5–2.6 cm
Summary
Fractures of the distal third of the tibia and fibula are relatively common fractures of long bones. The main etiologies of the fractures involve simple falls, motor vehicle trauma, or sports-related injuries as a result of axial compression and/or rotational forces [1,2,3]. Management of these fractures remains challenging to the surgeon. Open reduction and internal fixation is often favored for the improved ability to anatomically reduce displaced fractures, articular fractures. Open reduction and internal fixation generally involves two separate incisions: a medial incision to approach the distal tibia
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