Percutaneous drilling for osteonecrosis of the distal tibia following a pronation external rotation ankle fracture—a case report and literature review

Abstract

Introduction Posttraumatic osteonecrosis of the distal tibia is a rare but recognised complication of Weber C ankle fractures, frequently resulting in peri-articular collapse and subsequent joint destruction. To our knowledge, we report the only documented case of early percutaneous drilling of the defect. Methods Symptoms improved, MRI confirmed the resolution of the avascular area, and a peri-articular collapse was avoided. Conclusion We advocate that a high index of suspicion, early detection and drilling can encourage neovascularisation and prevent secondary joint destruction.