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Treatment of the distal fractures of the tibia: shall we fix the fibula?

OBJECTIVE: To compare the results of fibula fixation (or not fixation) in the treatment of fractures located in the distal third part of the tibia, by using intramedullary nailing and bridge plate. METHOD: 47 fractures in 47 patients were studied. Twenty-one patients were treated with non-reammed, interlocking intramedullary nailing, and 26 patients were treated with wide or narrow dynamic compressional plates (using a minimally invasive technique). All of the fibula fractures are located at the same level or below the tibia fractures. RESULTS: in the group of patients treated with fibula fixation, the average healing time was 14.6 weeks. In the group of patients treated without fibula fixation, the average healing time was 14.3 weeks. In the group of patients treated with fibula fixation it was observed a significantly smaller proportion of valgus angular deviation (6.3%) than in the group of patients treated without fibula fixation (32.3%). CONCLUSIONS: The benefits of fibula fixation still keeping controversial when tibial fractures are associates. Regarding fracture healing, there was no significant difference between the studied fracture groups.

Tibial Fracture; Fibular Fracture; Internal Fixation


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