Necessity of fixation of fibula in distal tibia fractures


  • Aashay Sonkusale Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Satyajeet Jagtap Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Hanuman Khedekar Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India
  • Pranav Keswani Department of Orthopaedics, Government Medical College and Hospital, Nagpur, Maharashtra, India



Distal tibia, Fibula fixation necessity, Fracture fibula


Background: Distal tibia fractures and concomitant fibula fracture associated with soft tissue injury present as common orthopedic problems. This study evaluates the need to fix fibula fractures which are associated with closed distal third tibia fractures.

Methods: An interventional observational study was undertaken to analyse the efficacy of fixation of fibula, in a Tertiary care hospital with a sample size of 78 patients which were divided into 2 groups of 39 patients each- one in which fibula was fixed (A)-with nail (A1); with plate (A2) and one in which fibula was not fixed (B). Cases were followed up for a mean period of six months post-operatively.

Results: The comparison of functional outcome among both groups showed that combined group A (A1+A2) had 4 (10.25%) excellent functional outcome as compared to 1 in group B (2.56%). Group A shows better functional outcome as compared to group B with significant statistical difference. The mean duration of bone union in Group A1 was 21.26±1.43 weeks, A2 was 21.08±1.38 weeks and in group B was 23.60±2.47 weeks showing a statistically significant difference.

Conclusions: Fixation of fibula proved to facilitate ease of reduction of tibia and better rotational and angular stability with a superior ankle range of motion. The method of fixation of fibula did not seem to impact the outcome as long as the alignment, length, rotation were not compromised. Wound complications are not uncommon with precarious skin around the ankle, and should be managed appropriately.


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Original Research Articles