الفهرس 
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Abstract
Introduction: Tibial pilon fracture constitutes 7% of all tibial fractures and approximately 1% to 10% of lower limb fractures. The final therapeutical decision is a well-balanced between anatomic reduction and soft tissue preservation as the handling of the soft tissue envelope are crucial in affecting pilon fracture outcome.Aim of the work: Evaluation the soft tissue healing after using the posterolateral surgical approach for fixation of tibial plafond fractures.
Patients and methods: This study included 30 patients, their ages ranged between 18 and 60 years. There were 14 males (46.7%) and 16 females (53.3%). The injury was caused by falling from height in 14 cases (46.7%) and by road traffic accident in 8 cases (26.7%) and by falling down in 8 cases (26.7%). In all cases the posterolateral approach was performed for ORIF of both tibia and fibula through single incision.Results: According to the scoring system 24 patients (80%) had good results, 6 patients (20%) had fair results. There were two patients (6.7%) with superficial wound infection, which were successfully treated with antibiotics. One patient (3.3%) suffered from skin edge necrosis at two sutures which improved by time. There was no presence of deep infection, wound breakdown or hardware exposure. The mean score of vancouver scar scale was 3.40±1.32 (range = 0.0- 6.0).The mean score of visual analog scale was 42.67±10.14 (range = 30-60).Conclusion: The posterolateral approach is a single incision approach that allows satisfactory wound healing. Being unfamiliar to many orthopedic surgeons and its limitation in fractures with anterior comminutions, it is not considered a standard technique for tibial plafond fractures. It may be a valuable alternative option when soft tissue envelope compromise is a major concern together with absence of anterior comminution.