Factors that Influence Soft-tissue Injury in Fractures of the Distal Tibia

Background: Soft tissue injury associated with fractures of the distal tibia is a predictive factor for a poor prognosis.The purpose of this study was to investigate factors associated with the need for a flap coverage after distal tibialfracture, and whether there was a difference in functional outcomes between patients with flap coverage or no flapcoverage for a distal tibial fracture.Methods: All fractures of the distal tibia treated in our department between ۲۰۱۰ and ۲۰۱۷ were reviewed. Thefunctional result was assessed using the SF-۳۶ Quality of Life Questionnaire, the Visual Analog Scale (VAS) whenwalking and the AOFAS scale (American Orthopedic Foot and Ankle Society).Results: ۱۳۲ distal tibia fractures were reviewed, of which ۵۱ required soft tissue flap reconstruction, which wasassociated with open fractures (P<۰.۰۰۱, OR ۵.۲۵), high energy trauma (P<۰.۰۰۱, OR ۱.۷)), the use of external fixation(P<۰.۰۰۱, OR ۱۲.۵) and the presence of vascular alterations on the Angio-CT scan (P<۰.۰۰۱). No significant differenceswere found in any of the scales that assessed the functional results between the group of patients who required softtissue flap reconstruction and the group of patients who did not.Conclusion: We found that the need for a soft tissue flap was associated with the following parameters: open fracture, highenergy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation tofunctional results, differences were not found between the group that needed coverage with a flap and the one that did not.Level of evidence: III

Keywords:

Distal tibia , Fractures , soft-tissue flap coverage , Soft tissue injury