DISTAL THIRD TIBIAL FRACTURE SURGERY WITH FIBULAR FIXATION: IS IT NECESSARY FOR UNION AND ALIGNMENT?

Abstract

Objective
 The management of distal third tibial fractures remain
 controversial. The aim of the present study was to
 evaluate whether concurrent fibular fixation changes
 union rates and aids in alignment in the case of distal
 third tibia fractures.
 Material and Method
 The study included 106 distal third tibia fracture
 operation cases in which the distance from the fracture
 to the plafond was between 3-12 cm at a single centre
 between January 2016 and June 2020. The patients
 were divided into three groups according to the status
 of the fibula: Group 1 (without fibular fixation with
 the presence of a fibula fracture, 47 cases), Group
 2 (concurrent fibular fixation with the presence of a
 fibular fracture, 38 cases) and Group 3 (intact fibula,
 21 cases). All fibular fixation surgeries were performed
 with locked plates (LCP) and tibial fixation with either
 LCP or intramedullary nailing (IMN). The primary
 outcome measures were union and alignment. Age,
 gender, AO classification, fibula fracture location,
 presence of an open fracture, implant type and time
 delay for surgery were also assessed.
 Results
 None of the variables except the presence of an open
 fracture was significant for the union rates or alignment.
 The union rate was significantly less if there was an
 open fracture in the concurrent fibular fixation group
 (p