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Extensile Antero- Lateral Approach to the Tibia

Extensile Antero- Lateral Approach to the Tibia. The most important advance in the surgical treatment of high-energy pilon fractures has been the realization that primary surgery must be delayed. However, open reduction with internal fixation requires an adequate incision to visualize the articular surface to restore intraarticular anatomy clearly. This article illustrates our extensile approach and its effect on soft tissue healing. The approach provides complete access to the ankle joint to achieve reduction and fixation of the articular surface, as far medially or laterally as necessary. It also allows easy placement of plates medially, laterally, or anteriorly. For fractures that are more proximal, plates can be placed subcutaneously from distal to proximal through the open incision.