Comparison of different locking plate fixation methods in distal tibia fractures

The aim of our study was to assess the outcome of locking plate fixation of distal tibia fractures and evaluate which surgical approach and method of plate fixation is related to better functional result and lower complication rate. A retrospective analysis of treatment of 45 patients was made. Patients were divided into two subgroups regarding surgical approach (medial vs anterior) and fixation method (bridge plating vs rigid fixation). Time from injury to full bone union was noted, and clinical outcome was assessed by AOFAS score. Nonunion was the most prevalent complication and was observed in 26.6 % of patients. Infection rate was 11.1 %. Higher rate of bone union complications was noted in the anterior approach group with anterolateral anatomical plate. Infection and re-operation rates were similar in all subgroups. There were no correlations between fracture extension, length of plate and screw placement with bone healing time and AOFAS score. Outcome of plate fixation of distal tibia fracture did not depend on the fixation method or surgical approach but, when possible, the medial plating via MIPO technique is a favourable method of treatment.