Anterolateral versus medial plating for comminuted intra-articulation distal tibia fractures: a biomechanical assessment

Comminuted, intra-articular distal tibia/fibula fractures remain a surgical challenge. It has been suggested that plates be applied on the compression side of the fracture; hence, medial plates for varus fracture patterns. No prior biomechanical investigations have examined this in a model that includes the tibia, fibula and syndesmotic tissue. Distal tibia and fibula comminuted intra-articular fractures with varus fracture pattern were generated in 12 specimens. Specimens were repaired using either an anterolateral plate or a medial plate and loaded in axial compression. The repair technique was evaluated using the construct stiffness. This study will guide the treatment of varus fractures, resulting in improved patient outcomes following these debilitating injuries.