A Prospective Study on the Functional Outcome of Anterolateral Plating for Distal Tibia Fractures
Background: This study was carried out to study the functional outcome of patients who underwent anterolateral plating for distal tibia fractures using the American Orthopaedic Society foot and ankle scoring, secondarily to study the relationship of various factors and the occurrence of complications post-operatively, and to relate the surgical duration with postoperative complications.
Materials and Methods: This prospective study includes 31 cases of distal tibia fractures in patients in the age group between 15–65 years. The patients included in the study underwent anterolateral plating for pilon fractures. The study was conducted in the department of Orthopaedics at a leading hospital in Kerala between August 2013 and December 2016. Ethical and scientific committee clearance was obtained.
Results: The average age of the patients in our series was 48.6 years ranging from 24-64 years, with a male preponderance (64.5 %). The radiographic classification included: 15 Type A Fractures (6 A1, 5 A2, 4 A3), 10 Type B Fractures (4 B1, 1 B2, 5 B3), and 6 Type C Fractures (3 C1, 3 C2, 0 C3). There were 2 Grade 1 open (A3 and B2) fractures and 1 Grade 2 Open fracture (C2) according to the Gustilo-Anderson classification. 61.3% of the patients underwent their surgery within 3 days from the day of injury. The average duration of surgery was 93 minutes.
Conclusion: All patients (n = 18) whose surgery was completed within 93 minutes had an excellent outcome. Patients whose surgery time exceeded 93 minutes had a greater chance of having a poor functional outcome (p <0.05). There was a statistical significance between the functional outcome and the patients who underwent surgery within 3 days from the day of injury. The incidence of complications was higher in the higher OTA classes but there exists no statistical significance in its occurrence. There was a statistical significance between the Functional Outcome and the OTA class. The greater the degree of comminution and intraarticular involvement, the worse the functional outcome. This is evidenced by the fact that the OTA class A being extraarticular fracture has a statistically significant better functional outcome than OTA Type B fractures which in turn has a statistically significant better functional outcome than OTA type C fractures.