Comparative Prospective Study between Medial and Anterolateral Plating for Distal Tibial Fractures

Distal tibia fractures pose significant challenges for orthopaedic surgeons due to the region's complex anatomy and biomechanical demands. Medial and anterolateral plating are two prominent surgical techniques developed to address these fractures, each with distinct advantages. Medial plating aims to stabilize the fracture while minimizing soft tissue disruption, whereas anterolateral plating leverages load distribution for enhanced stability. Both methods are effective in fracture reduction, stability, and tissue preservation; however, debate persists regarding their relative benefits. Tibial pilon fractures, which affect the weight-bearing surface of the distal tibia, can lead to extended recovery times and impose substantial socioeconomic costs. These fractures, though rare (1% of lower limb fractures), can result from low-energy torsional forces or high-energy trauma, the latter causing significant bone fragmentation and soft tissue damage. Conservative treatments, such as traction and early mobilization, have proven insufficient for complex fractures. This study compares the outcomes of medial and anterolateral plating for distal tibial fractures, focusing on fracture reduction, implant positioning, union rates, complications, and functional recovery. Using the AO/OTA 43 and Ruedi-Allgower classification systems, we aim to provide insights into the optimal fixation strategy based on fracture type and severity.