Comparison of the exposure of the distal tibial articular surface for posterior pilon fractures via a medial or lateral malleolar osteotomy: a preliminary cadaveric study

The medial and lateral approaches can significantly expose the distal articular surface of the posterior tibia to a large extent after medial and lateral malleolus osteotomies. A suitable individualized surgical approach conducive to adequate exposure for the operation should be considered according to the position of the main fracture fragments on the posterior articular surface and the proportion of their transverse distance to the posterior pilon variant fracture. These preliminary data require clinical validation. In addition, an intra-operative soft tissue stretch enlarges the visual field by approximately 10% regardless of the approach.