osterior approach of the distal fibula with luxation of the peroneous tendón

técnica quirúrgica

Abstract

Objective: The malleolar fractures associated with posterior malleoli fracture of the tibia have poor result than others malleoli fractures. Usually we do ostheosynthesis when the fragment is bigger than 25% of the articular surface. Although recent studies suggest rutinari fixation. The reduction and fixation of these fractures have been describe by anterior approach, percutaneous osteosynthesis or with de classical poster lateral approach in between the Achilles tendon and the posterior border of de peroneus malleoli. Methods: We describe a surgical technique in which we use a posterior approach of de peroneus Malleoli, with the opening of the peroneus retinaculum, and with anterior luxation of the peroneus tendon. Buy this way we arrive to the deep plane, opening de peroneus fascia and reflect de flexor hallux longus to the lateral plane to arrive to the posterior distal tibia. Conclusion: In conclusion, we can reduce and fixate de fracture of the posterior malleoli of the tibia, the distal fibula fractures and make the osteosynthesis either with lateral plate, posterior even anterior platting in distal fibula. Also we can reduce de synthesmotic injury and it has a very important advantage of protect de sural nerve of traumatic injury because the pathway is far away from it. Although caution is recommended.