Comparative study of functional outcome and complication in low profile recon plates vs anatomical anteromedial distal tibial plate in extra articular distal 4th tibia fibula fracture

Background: Treatment of distal tibia fractures is challenging because of its subcutaneous location, poor vascularity and limited soft tissue envelope. Various modalities of surgical treatment such as intramedullary nailing, open reduction and internal fixation (ORIF) with conventional plate osteosynthesis and external fixation have reported good functional outcomes but had a high complication rate. We decided to review the results of treatment of extra articular distal 4th tibia fracture using low profile plates. Methods: The 30 patients with distal 1/4rd tibia extra-articular fractures with or without associated fibula fractures were treated with anatomical anteromedial distal tibia plate vs low profile recon plate. The present prospective study was conducted in department of orthopaedics, MGMMC and M. Y. hospital, Indore between January 2023- May 2024. Results: All fractures had excellent clinical and functional outcome, with an average operative time of 49 minutes. The age of the patients ranged from 18 to 60 years (mean 42.7 years). Assessment on basis of Karstorm and Oleruad score at 6-month post treatment showed that majority of patients had excellent score (56.7%). Poor outcome was reported in only 3.3% patient. Most common complication was ankle stiffness in both type of plating groups followed by deep infection. Conclusions: Both types plate showed similar functional outcome. However, low profile recon plate had lesser complications as compared to anatomical plates i.e., hardware like sensation, wound dehiscence ankle stiffness, deep infection and screw breakage.