Comparative Study Of The Medial And Lateral Anatomic Plate In The Treatment Of Distal Tibial Fractures

Aim To evaluate the clinical results of anatomical plate in treatment of the distal tibialfractures，and summary the clinical results of the medial and lateral anatomical plate intreatment of the distal tibial fractures，provide ideas and choices to the clinical treatmentfor all levels of hospital.Methods Between January2007and January2013，86cases were followed andinvestigated retrospectively in the department of orthopaedics，Shanghai ChangningHospital. The medial anatomical plate group was47cases，the lateral anatomical plategroup was39cases，the operative time、treatment efficient and complications wereanalyzed and compared. Outcome was assessed using Mazur ankle function scoring system.The SPSS20.0was used in standard statistical analysis，the t test was used in operationtime and healing time and the χ2test was used in excellent rate and complication rate ofpostoperative. p<0.05was considered statistically significant.Results All patients got follow up from9months to24months，with the meanfollowing time18months．In the medial anatomical plate group，excellent and good ratewas80.85%. In the lateral anatomical plate group, excellent and good rate was87.18%.There were no significant difference between medial and lateral anatomic plate group bythe average operative time and the fracture healing time (p>0.05). The incidence ofcomplications in the medial anatomic plate group was higher than that of the lateral group(p<0.05). The main difference between the two groups was in the complications of woundinfection cracking and soft tissue injury, but there were no difference in breakage anddelayed or abnormal fractures healing. The excellent and good rate of postoperative in thelateral anatomic plate group was similar to that of the medial group(p>0.05), and there wasno statistically significant difference．Conclusion Overall, medial and lateral anatomic plate both have good indications inthe treatment of distal tibial fractures. But there were more muscle and soft tissue coveredin the lateral distal tibia, the complications were less in the lateral group than the medial plate．So the indications of plate were expanded. The lateral anatomic plate was advantagein decreasing soft tissue complications and increasing the functional recovery. Thereasonable treatments were depended on the understanding of the anatomical features，thefracture types and the judgment of the medial soft tissue.