Anteromedial and Anterolateral Dynamic Compression Plating in Tibial Diaphyseal Fractures

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Rattasat Sudnongbua


Rational: Treatment of tibial shaft fractures with dynamic compression plates provides results equal to closed interlocking nails but results in a lower incidence of malalignment. Anteromedial plating offers a biomechanical advantage because the plate is fixed on the tension side of the tibia. A disadvantage of anteromedial dynamic compression plates, however, is a higher infection rate than with anterolateral plating.

Objectives: This research aimed to compare the results and complications of treatment of tibial diaphyseal fractures with anteromedial and with anterolateral plating.

Methods: This retrospective study compared patients with tibial shaft fractures who had undergone surgery between 1 January 2010 and 31 December 2014 using dynamic compression plates: 96 with anteromedial plating and 84 with anterolateral plating.

Results: Of anteromedial plating cases, two were found to have non-union, eight had infection, and there were no instances of malalignment.  Among the cases of anterolateral plating, there was one non-union, one case of infection, and no cases of malalignment. There were no significant differences in rates of non-union or malalignment between the two plating methods (p < 0.05). The infection rate in the anterolateral group, however, was significantly lower than that in the anteromedial group (p < 0.05).

Conclusions: Treatment of tibial diaphyseal fractures both with anterolateral and with anteromedial dynamic compression plates show an equally satisfactory union rate and incidence malalignment; however, anterolateral plating has a significantly lower infection rate.

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