To Study Outcome Analysis of Fibular Fixation Adjuvant to Distal Tibial Nail in Fractures of Distal Third Tibia and Fibula

Objective: To study the outcome of fibula fixation adjuvant to distal tibia nail in fractures of distal third tibia and fibula. Method: 20 patients including 15 males and 5 females with average age of 35. 65 years, who had fractures of distal third tibia and fibula with right side dominance, majority due to road traffic accident were treated in Department of Orthopaedics, Gandhi Medical college and associated Hamidia hospital, Bhopal and were followed up for the study. In all the patients fibula was fixed with one-third tubular plate prior to intramedullary nailing of tibia. The average duration of follow up was 12. 05 months. Results: In the present series total 20 patients were included in the study. The average age of the patient was 35. 65 years. The males outnumbered the females, male:female ratio was 3:1. Road traffic accident accounted for 60% of the cases. According to AO Muller's classification A1 was the most common type of fracture. The fracture was two times more common on the right side. The mean injury- surgery interval was 4. 9 days, the average healing time was 14. 85 weeks. The average valgus angulation at the fracture site was 2. 55 degrees. Complications were seen in 20% of cases. According to Johner and Wruhs's criteria there were excellent results seen in 7 patients, good in 11 and fair in 2 patients. Conclusion: Distal tibia and fibula fractures particularly at the same level has inherent instability therefore needs fixation of both medial as well as lateral columns. Locked intramedullary nailing along with plate fixation of fibula gives high beneficial results. The competitive nature of fibular fixation in union is raised, but in present series high rates of union, low number of complications and good quality of functional outcome were achieved.