title: The role of fibular fixation in the treatment of tibia diaphysis distal third fractures.
abstract: BACKGROUND
  Combined fractures of the distal third of tibia diaphysis and fibula diaphysis are a common orthopedic injury. There is an ongoing debate about the necessity of fibular fixation when associated to distal third tibial fracture. This study aims at evaluating the role of fibular fixation in the treatment of distal third tibial fractures.
  
  
  OBJECTIVE
  We hypothesized that fixation of the fibula increases the stability of fixation in distal third tibial and fibular fractures.
  
  
  METHODS
  In a randomized clinical trial, 53 patients with concomitant fractures of tibia and ipsilateral fibula at distal third level were recruited in this study during a 23-month period. Patients were randomized in two groups: patients with fibular fixation (case group) and without fibular fixation (control group). The patients were followed up for at least 6 months postoperatively.
  
  
  RESULTS
  There were seven cases exhibiting malalignment on immediate postoperative radiographs. Six of them were in group II (control group) and one was in group I (case group) (P=0.084). We didn't find nonunion in group I and we found three patients in group II (P=0.141). Infection was one in group I and two in group II on gustillo II injuries (P=0.516).
  
  
  CONCLUSIONS
  Despite its low count of patients, our study didn't show any advantage to fix the fibula fracture associated to distal third of tibia diaphysis fracture. It didn't show either an increase of complication after fibula open reduction and internal fixation.
  
  
  METHODS
  Level III. Randomized prospective study.
authors.affiliation: Department of Orthopedics Surgery, Shohada Teaching Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. rouhani.m.d@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Rouhani
authors.forename: A
authors.initials: A
authors.lastname: Elmi
authors.forename: H
authors.initials: H
authors.lastname: Akbari Aghdam
authors.forename: F
authors.initials: F
authors.lastname: Panahi
authors.forename: Y
authors.initials: Y
authors.lastname: Dokht Ghafari
mesh_terms: D000293:Adolescent; D000328:Adult; D018483:Diaphyses / Q000293:injuries; D005260:Female; D005360:Fibula / Q000293:injuries* / Q000601:surgery*; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013978:Tibial Fractures / Q000601:surgery*; D055815:Young Adult