Abstract: The tibia is exposed to frequent injury. Distal tibial metaphyseal fractures are often the result of high-energy trauma, usually associated with distal fibular fractures. The presence of the ankle joint allows rotatory deformity after fracture, and care should be taken during reduction to correct such deformity. Fixation of fibular fractures in distal tibial metaphyseal fractures is controversial, although fixation of the fibular fracture by a plate and screws partially stabilizes comminuted fractures of the distal tibial shaft or metaphysis and considered in distal tibial fractures treated with intramedullary fixation to prevent valgus deformity even there is increased potential for delaying the tibial fracture healing.
Objectives: The purpose of this study was to compare the functional and radiological outcome of fractures of distal third tibia and fibula treated by interlocking nail of tibia with fibular plating and without fibular plating.
Material and Methods: A total of 24 patients who had fractures of lower third tibia and fibula are included in this study. 24 patients were divided into two groups A and B (12 patients in each group) based on fibular fixation.
Results: Functional results were evaluated based on classification system for result of treatment by Johner and Wruhs criteria. Functional Outcome according to Johner and Wruhs criteria based on clinical rotational alignment, radiological valgus angulation and ankle range of movements, in group A 7 patients (58%) had good results and 5 patients (42%) had fair results. In group B 8 patients (67%) had good results and 4 patients (33%) had fair results (p=1.00 statistically not significant).
Conclusion: Based on the results of the study, it was confirmed that fixation of fibula first, along with interlocking nailing of the tibia maintains limb length and decreases the malalignment and malrotation of the tibia in distal third fractures of tibia and fibula as compared with only interlocking nailing of tibia in distal third fractures of tibia and fibula.
