Study: Fibula fixation not necessary to maintain alignment i
Recently published results showed fibula fixation is not necessary to obtain or maintain alignment in the treatment of distal tibia fractures when modern nailing techniques are used.

Researchers performed intramedullary nailing without fibula fixation in 122 patients with distal tibia fractures, of which 30% were open fractures and 70% were closed fractures. Patients with more than 5° of varus/valgus angulation or anterior/posterior angulation on the initial postoperative or final anteroposterior and lateral X-rays were defined as having malalignment and malunion, according to researchers.

Results showed the presence or level of fibula fracture was not predicted by the mechanism of injury. When the fibula was fractured at the level of the tibia fracture upon presentation, researchers found varus/valgus and procurvatum/recurvatum angulation was greatest. According to results, nailing in relative extension, transfixion external fixation and clamps at the fracture site were the most common intraoperative reduction aids. Researchers also found malalignment, malunion or the change in alignment during union, which averaged 0.9°, was not influenced by Orthopaedic Trauma Association fracture type or level/presence of fibula fracture.
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