Comparative Study of Distal Tibia Fracture Managed by Medial Vs Anterolateral Approach

Sumit Verma, Abhishek Verma, Prakash Jha

Abstract: Background: Distal tibial fractures are challenging because of the subcutaneous location of the bone, limited soft-tissue coverage and frequent metaphyseal or articular involvement. Medial and anterolateral locking compression plate (LCP) fixation are established options, but their clinical and soft-tissue outcomes may differ. Aim: To compare the clinical, radiological and functional outcomes of distal tibial fractures treated with medial versus anterolateral LCP fixation. Materials and Methods: This prospective comparative study included 60 adults with distal tibial fractures treated at the Department of Orthopaedics, Hind Institute of Medical Sciences, Sitapur. Thirty patients underwent medial LCP fixation and 30 underwent anterolateral LCP fixation. Fracture morphology was assessed using AO/OTA and R?edi-Allg?wer classifications and soft-tissue injury using the Tscherne-Oestern system. Operative time, blood loss, hospital stay, radiological union, full weight bearing, ankle range of motion, AOFAS score, OMAS category and postoperative complications were evaluated. Results: Mean operative time was 104.6 ± 15.1 minutes in the medial group and 92.8 ± 13.4 minutes in the anterolateral group (p = 0.003). Blood loss was 218 ± 44 mL versus 178 ± 36 mL (p = 0.001), and hospital stay was 8.7 ± 2.2 versus 6.9 ± 1.8 days (p = 0.008). Radiological union occurred at 20.8 ± 4.2 versus 17.9 ± 3.5 weeks (p = 0.02), while full weight bearing was achieved at 12.1 ± 2.5 versus 10.2 ± 2.0 weeks (p = 0.04). Mean ankle range of motion was 52.4 ± 8.7° versus 58.9 ± 8.3° (p = 0.03), and mean AOFAS score was 64.3 ± 8.7 versus 71.6 ± 8.4 (p = 0.01). Excellent AOFAS outcomes occurred in 40.0% and 60.0% of patients, respectively. Any postoperative complication occurred in 43.3% of medial and 20.0% of anterolateral cases (p = 0.02). Conclusion: In this cohort, anterolateral LCP fixation was associated with shorter operative time, lower blood loss, shorter hospitalization, earlier union and weight bearing, better ankle motion and higher functional scores, with fewer recorded complications. Approach selection should nevertheless be individualized according to fracture morphology and soft-tissue condition.

Keywords: distal tibia fracture; locking compression plate; medial plating; anterolateral plating; AOFAS; OMAS; fracture union; postoperative complications

How to Cite?: Sumit Verma, Abhishek Verma, Prakash Jha, "Comparative Study of Distal Tibia Fracture Managed by Medial Vs Anterolateral Approach", Volume 15 Issue 9, September 2026, International Journal of Science and Research (IJSR), Pages: 2000-2003, https://www.ijsr.net/getabstract.php?paperid=MR26929124829, DOI: https://dx.doi.org/10.21275/MR26929124829

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