A prospective study of functional outcome of internal fixation of fibula in addition to tibia in distal both bone leg fracture

Introduction: Tibial diaphyseal fracture is one of the most common long bone fracture seen and distal 1/3rd accounts for about 20-30% of them There are high chance of malunions, delayed union, ankle stiffness due to prolonged immobilization ,valgus or varus deformity of tibia. The most common injury associated with tibial diaphyseal injury is that of same side fibular fracture Injury to fibula may occur in about 80% of these patients and fibula fracture occurs either at the same level or at a different level and sometimes segmental too In distal both bone leg fractures , there is disruption of the tibiofibular syndesmosis and interrosseus membrane. A study on fixation of fibula is done to find out the effect on reduction of the tibia fracture and restoration of stability. Thus it becomes important to study the outcome of fixation of fibula along with tibia fixation. Materials and Methods: Data will be collected from patients fulfilling the inclusion criteria, attending either OPD or inpatient of Chigateri General Hospital and Bapuji Hospital attached to JJM Medical college, Davanagere. The study will include patients with distal both bone fracture of leg seen as both out-patient and in-patient fulfilling the inclusion criteria. The patients are assessed both clinically and radiologically. Other associated injuries are noted. The patients undergoing fixation of fibula by closed reduction and TENS nailing or rush nailing in addition to tibia fixed with intramedullary interlocking nail or distal tibial plating. And are reviewed post operatively, at 6wks, 3 months, and 6 months radiologically and 1 year clinically. Results: This study consist of 30 cases of distal both bone leg fractures with fibula by closed reduction and TENS nailing or rush nailing in addition to tibia fixed with intramedullary interlocking nail or distal tibial plating..For 17 (56.7%) recovery was excellent, for 9 (30%) recovery was god, and for 4 (13.3%) recovery was fair.19 patients(63.33%) had 0-degree of deformity and 2 (6.7%) had 1-degree varus deformity.5(16.7%) had 1 degrees valgus , 4(13.3%) had 2-degree valgus deformity. Conclusion: Treatment of distal third both bone leg fractures by fixation of fibula by closed tens/rush nailing followed by tibia, nailing/plating is useful in anatomical reduction of tibia & reduced malalignment of tibia with good ankle functions. Further Randomized control studies are needed to assess the long term functional outcome in these patients.