Minimally invasive percutaneous plate osteosynthesis of fractures of the distal tibia

Fractures of the distal tibia are notoriously difficult to treat, and traditional methods of fixation are often fraught with soft-tissue complications. With recent emphasis on meticulous handling and preservation of the soft-tissue envelope, minimally invasive percutaneous plate osteosynthesis has become a safe and reliable method of treating these fractures. This technique involves conventional open reduction and internal fixation of the fibula and spanning external fixation of the tibia until the soft-tissue swelling subsides. Subsequently, limited open reduction and internal fixation of displaced articular fragments is performed through small incisions based on CT evaluation. This is followed by minimally invasive percutaneous plate osteosynthesis of the tibia, in which the plafond is attached to the tibial shaft using a variety of commercially available plates.