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

Document Type : RESEARCH PAPER


1 Department of Plastic and Reconstructive Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain

2 Department of Orthopaedic Surgery; La Paz University Hospital-IdiPaz, Madrid, Spain


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 tibial
fracture, and whether there was a difference in functional outcomes between patients with flap coverage or no flap
coverage for a distal tibial fracture.
Methods: All fractures of the distal tibia treated in our department between 2010 and 2017 were reviewed. The
functional result was assessed using the SF-36 Quality of Life Questionnaire, the Visual Analog Scale (VAS) when
walking and the AOFAS scale (American Orthopedic Foot and Ankle Society).
Results: 132 distal tibia fractures were reviewed, of which 51 required soft tissue flap reconstruction, which was
associated with open fractures (p <0.001, OR 5.25), high energy trauma (p <0.001, OR 1.7)), the use of external fixation
(p <0.001, OR 12.5) and the presence of vascular alterations on the Angio-CT scan (p <0.001). No significant differences
were found in any of the scales that assessed the functional results between the group of patients who required soft
tissue 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, high
energy of trauma, presence of skin necrosis, the use of external fixation and the existence of vascular injury. In relation to
functional results, differences were not found between the group that needed coverage with a flap and the one that did not.
Level of evidence: III


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Volume 9, Issue 2
March 2021
Pages 152-157
  • Receive Date: 08 July 2019
  • Revise Date: 04 March 2020
  • Accept Date: 23 March 2020
  • First Publish Date: 01 March 2021