Functional outcome of the effect of fibular fixation on malaligned fractures of lower third tibia-fibula treated by interlocking nail of the tibia

Abstract

Background & Objectives: In the treatment of fractures of the distal third of the tibia and fibula treated by interlocking nailing of the tibia, the role of fixing the fibular fracture is not clearly defined. This study was undertaken to assess the benefits of fixation of the fibula clinically, radio graphically and functionally in fractures of the lower third of the leg.Methods: 18 patients with fractures of the lower third of the leg were followed up for an average of fourteen months. The patients were divided in to two groups based on whether fibula was fixed or not, the fracture tibia being treated with interlocking intramedullary nailing in all the cases. In the follow up the two groups were compared for radiological differences in the angulation at the fracture site, clinical and functional outcome at the end of six months, time of union and complications.Results: The demographics of the two groups were similar with respect to age, sex, side of fracture, fracture classification and nature of the injury. The average valgus angulation was significantly less in the group where fibula was fixed (p=0.009). The outcome of the two groups for clinical ankle score, measured at six months follow up, time of union and complications showed no significant differences.Interpretation & Conclusion: Fixation of the fibula decreases the malalignment of the tibia in distal third fractures of the tibia and fibula treated with interlocking nailing of the tibia.