Union Following Biological and Rigid Fixations of Distal Tibia Extra-articular Fractures



Division of Orthopedic Surgery, Department of Surgery, American University of Beirut Medical Center, Beirut, Lebanon


Background: Distal tibia fractures are among the most common bony injuries, with a significant rate of nonunion and
delayed union. There are multiple methods for the management of distal tibia fractures. Among the plating methods,
there are bridge plating and compression plating techniques. There is still a lack of evidence about whether one method
has a higher rate of union than the other. The present study aimed to assess the union rate of extra-articular distal tibia
fractures using biological fixation with bridge plating and rigid fixation with compression plating.
Methods: This retrospective analysis was performed on 41 adult patients with distal tibia fractures. The subjects
were divided into two groups based on the fixation method, namely bridge plating and compression plating. Baseline
characteristics, fracture characteristics, and union status were analyzed and compared in this study.
Results: Baseline and fracture characteristics were similar between the groups. Only higher translation in any planes
was noted in the bridge plating group (2.80±3.04 mm; P<0.001). As for union status, the rates of the union during 3
months and delayed/no union were similar between the two groups (P=0.18). During a 6-month follow-up, 92% and
93.8% of the patients achieved union in the bridge plating and compression plating groups, respectively.
Conclusion: Rates of delayed union and nonunion are similar regarding extra-articular distal tibia fractures treated
with either bridge plating or compression plating.
Level of evidence: III


Main Subjects