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Combined fractures of the distal third of tibia diaphysis and fibula diaphysis are a common orthopedic injury. Confusion still exists about the necessity of fibular fixation in all distal third tibial fracture. This study aims at evaluating the role of fibular fixation in the treatment of distal third tibial fractures.40 patients with concomitant fractures of tibia and ipsilateral fibula at distal third level were included in this study during a 48 month period. Patients were randomized in two groups: patients with fibular fixation (group I) and without fibular fixation (group II). The patients were followed up for at least 1 year follow up postoperatively. Johner And Wruh’s Criteria was used for evaluation of functional outcome. Excellent and good results were seen in majority of the patients (85%) in group I as compared to group II (65%). Infection was seen in one patient in group I and two in group II with Gustillo-Anderson II injuries. Even though our study was limited to only 40 patients, still it proved that functional reduction of tibia could be achieved easily after fixing the fibula even without the use of intra-operative fluroscopy. With fibular fixation length of the limb was achieved and biomechanically we were able to restore the minimal amount of weight that transmits through an intact fibula. Due to more stability in fixation use of supplimentary splints were not needed and allowed early post operative mobilization and early weight bearing.

Managements of Distal Third Both Bone Leg Fractures By Tibia Interlocking – is Fibular Fixation Mandatory?