Functional and radiological outcome of distal tibial fractures treated with anterolateral plate compared with medial locking plate.

Objective: Tibia is commonly fractured long bone with subcutaneous location vulnerable to frequent injury. Lack of proper vascularity and soft tissue cover leads to delayed healing and higher complication rates in the distal fractures of tibia. Adult distal metaphyseal extraarticular and intraarticular fractures of tibia are a challenge for an experienced surgeon. Important clinical variables affecting the clinical results are the type of fracture, associated soft tissue injury, method of treatment and the quality of reduction. This study aims to evaluate and compare clinical and functional outcome of medial and anterolateral locking plates in these fractures.Material and Methods: A prospective study was conducted at NIMS University Rajasthan from July 2019 to May 2021. Total 36 patients meeting the inclusion criteria were included in the study, 30 were males, 6 females. Mean age was 38.789.09 years. 5(13.9%) were AO type A1, 17(47.2%) were A2, 7(19.4%) were A3 and 7(19.4%) were C1. 32(88.9%) had associated fibula fractures. 28(77.8%) were closed fractures and 8(22.2%) were Gustilo grade I open fractures. Mean interval between injury and surgery was 8.53.62 days. Anterolateral LCP was used in 22 patients (Group A) and medial LCP was used in 14 patients (GroupB). The results were analyzed using Microsoft excel and SPSS software. P value of <0> Results: Mean time taken for full weight bearing and radiological union was 17.4 weeks in Group A and 18.2 weeks in Group B with a standard deviation of 5.79. Mean functional score was 80.82 in Group A and 78.50 in Group B with a p value of 0.523 which was not statistically significant. Number of early complications in Group A was 3 and Group B was 8, while the number of late complications in group A was 2 and group B was 2 respectively.Conclusion: Both medial plating and anterolateral plating yields comparable functional outcome in our study. Complication of superficial infection, wound dehiscence was observed higher with medial plate. Authors would recommend use of anterolateral plates in distal tibia fractures where either approach or plates could be used.