Postero-medio-anterior approach of the ankle for the pilon fracture

A good view of the operative field is important for better reduction and fi xation in surgical treatment of fractures. The exposure of the ankle joint for the pilon fracture is commonly through the anterior approach, or combin ed with the medial approach. But sometimes it is still difficult to have co mplete viewing of the articular surface and to apply internal fixation by t hat approach. In recent years, we developed a "postero-medio-anterior" appr oach of the ankle joint by one incision. This approach provides an excellen t exposure of the anterior, medial and posterior aspects of the ankle joint with a clear view of the articular surface. In our 45 cases of pilon fract ure during 1991 to 1995, there was no incisional injury to the neurovascula r bundle, Superficial wound edge necrosis was noted in two cases which heal ed later without further procedure. Therefore, we recommend this approach a s a simple and reliable incision for open reduction of pilon fractures (C) 2000 Elsevier Science Ltd. All rights reserved.