Background: Treatment of distal tibial metaphyseal fractures is
often challenging and no single technique has been unanimously
advocated. Open reduction and internal fixation with plates and
screws allows better restoration of anatomical alignment but with
more soft tissue complication. Simultaneous fixation of the fibula
is not universally carried out. This study aims at evaluation of the
outcome of plating technique and the effect of fixation of fibula fracture
in treatment of distal tibial metaphyseal fractures.
Material and methods: Thirty-one cases (14 cases in Group A
with concomitant distal fibula fracture and 17 cases in Group B without
distal fibula fracture) were analyzed retrospectively for the mean
duration of full weight bearing, mean union time and complications,
and compared.
Results: The mean time for full weight bearing and radiological
union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group
B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively.
16.1% of cases had post-operative complications including one case
of deep infection and malalignment of 6 degree varus (following
delayed union) was seen in one case of Group A. Range of motion
(ROM) at ankle was not problem in any of the cases except the one
delayed union which had 5 degrees of dorsiflexion and 15 degrees of
Conclusion: Open reduction and internal fixation with plate and
screws in distal tibial metaphyseal fracture is more economic means
of treatment modality with comparable incidence of post-union
malalignment and union time,though more soft tissue complications
compared to other modalities. Fixation of fibula fracture aids in
reducing the incidence of malalignment.

Keywords: Distal tibial metaphyseal fracture, Open reduction and internal fixation, Non-locking buttress plate