title: Intramedullary nailing and plate osteosynthesis for fractures of the distal metaphyseal tibia and fibula.
abstract: OBJECTIVE
  To assess the results of concurrent intramedullary nailing plus plate osteosynthesis for fractures of the distal tibia and fibula.
  
  
  METHODS
  15 men and 10 women (mean age, 35 years) with concurrent fractures of the distal tibia and fibula underwent intramedullary nailing (for the tibia) and plate osteosynthesis (for the fibula). 17 fractures were type A1, 6 type A2, and 2 type A3. Compound type IIIB or more extensive fractures were excluded.
  
  
  RESULTS
  The mean follow-up duration was 2 years. The mean time to bone union was 20 weeks. Six patients underwent dynamisation and 4 bone grafting. Two patients had malalignment (angulation of >5 degrees in any plane), but none was rotational. No patient had shortening, hardware breakdown, or deep-seated infection. Two patients had superficial cellulitis at the site of the distal locking screws.
  
  
  CONCLUSIONS
  Concurrent intramedullary nailing and plate osteosynthesis for fractures of the distal tibia and fibula is effective in preventing malalignment. Plate osteosynthesis for the fibula provides additional stability even when a single distal locking bolt is used to fix the intramedullary nail to the tibia.
authors.affiliation: Department of Orthopaedics, GMC Jammu, India.
authors.forename: Ajay
authors.initials: A
authors.lastname: Krishan
authors.forename: Chetan
authors.initials: C
authors.lastname: Peshin
authors.forename: Dara
authors.initials: D
authors.lastname: Singh
mesh_terms: D000328:Adult; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D001858:Bone Nails; D001860:Bone Plates; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome