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Year : 2023  |  Volume : 38  |  Issue : 1  |  Page : 39-53

Comparative prospective study between medial and lateral distal tibial locking compression plates for distal third tibial fractures

1 Department of Orthopaedic, RNT Medical College Hospital, Udaipur, Rajasthan, India
2 Max Super Speciality Hospital, Mohali, Punjab, India

Correspondence Address:
Johney Juneja
Department of Orthopaedic, RNT Medical College Hospital, Udaipur 313001, Rajasthan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jbjd.jbjd_6_23

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Purpose: The surgical method of repairing distal tibial fractures remains controversial. Open reduction and plating constitute a popular method that can result in good fixation and retention of the achieved position. The usual approach for open plating is anterior. Although it offers good exposure to the tibia, the medial plating is at high risk of wound problems and nonunions. Also, if fixation of the fibula is required, an additional incision must be made on the lateral side of the shin. Lateral plating using a single lateral approach for treating distal tibial and fibular fractures has been reported to have good results; however, most of these studies were small series. Materials and Methods: This prospective clinical study involved 40 patients with distal tibial fractures admitted in Department of Orthopaedics, RNT Medical College and Hospital, Udaipur, Rajasthan, India, from December 2021 to November 2022. Of these, 20 patients were allotted in each group, that is, Group A and Group B. Group A is designated for patients those are operated with distal tibia medial locking compression plate (LCP). Group B is designated for patients those are operated with distal tibia anterolateral LCP. Results: All patients achieved union at the end of study. The mean time for fracture union was 24.6 weeks with medial plating group and 24.2 weeks with anterolateral plating group. In medial plating group, callus appeared at an average of 13 weeks and in anterolateral plating group, callus appeared at 12 weeks. Out of 20 patients in medial plating group, 11 patients had excellent Olerud and Molander ankle (OMAS) score and nine had good OMAS score at final follow-up. Out of 20 patients in anterolateral plating group, 13 patients had excellent OMAS score and seven patients had good OMAS score. The average OMAS score for Group A was 88.5 and for Group B, it was 90. Conclusion: Lateral plating of distal tibia is safe and feasible, which can provide biological fixation and prevent the soft tissue complications associated with medial plating.

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