الفهرس 
Relevant AnatomyOnly 14 pages are availabe for public view
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Abstract
The extra-articular distal tibia facture considered to be one of the most common fracture types, which mainly can result from simple falls in osteoporotic patients, traffic accidents, or sports-related injuries as a result of axial compression and/or rotational forces.
The decision to treat these fractures conservatively or operatively depends mainly on the fracture pattern and soft tissue status, usually conservative treatment leads to unacceptable results. Intramedullary nailing, plate osteosynthesis, and external fixation considered the main lines of operative intervention. However, there is no consensus for the optimal choice or optimal surgical technique.
Open reduction and internal fixation require extensive soft tissue dissection with consequent periosteal injury even in expert hands. High rates of complications including infection, wound dehiscence, delayed union, and nonunion have been reported.
External fixation has an established place in the treatment of distal tibial fractures, particularly when associated with significant soft tissue injury. Ilizarov frames, ankle-spanning, and hybrid constructs have been proposed either as a sole treatment or more frequently in conjunction with limited internal fixation. In addition, external fixation can be used as a preliminary reduction and fixation tool. Complications of external fixation include the development of pin track infection, malunion, or non-union.