title: Necessity for fibular fixation associated with distal tibia fractures.
abstract: BACKGROUND
  Intramedullary (IM) nailing is a well-accepted treatment for distal third tibia fractures in combination with injury to the fibula. However, the indications for operative stabilisation of the fibula remain controversial.
  
  
  METHODS
  The authors performed a retrospective review on a consecutive series of patients who underwent intramedullary nailing of a non-comminuted distal third tibia fracture with or without fibular fixation at a Level I urban trauma centre. A review of surgical records identified 120 patients who initially were included in this study, while a total of 98 patients who met the inclusion criteria were included in the final analysis.
  
  
  RESULTS
  Our results found no difference in the mean value of coronal and sagittal plane alignment in both the immediate post-operative and follow-up time periods. We also saw no statistically significant difference when comparing malalignment between patients treated with or without fibula fixation. There were no deep infections between the two groups. No significant differences were seen between the fibular fixation group and the non-fixation group. Distal screw removal due to prominence or pain was the most common reason for future surgery in both groups.
  
  
  CONCLUSIONS
  These findings suggest that the addition of fibular fixation does not affect whether or not alignment is maintained in either the immediate post-operative or short-term follow-up period.
authors.affiliation: Department of Orthopaedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215, USA. Electronic address: drbentaylor@gmail.com.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Taylor
authors.affiliation: Department of Orthopaedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215, USA.
authors.forename: Brandi R
authors.initials: BR
authors.lastname: Hartley
authors.affiliation: Department of Orthopaedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215, USA.
authors.forename: Nathan
authors.initials: N
authors.lastname: Formaini
authors.affiliation: Department of Orthopaedic Surgery, Grant Medical Center, 285 East State Street, Suite 500, Columbus, OH 43215, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Bramwell
mesh_terms: D000328:Adult; D000368:Aged; D017760:Bone Malalignment / Q000000981:diagnostic imaging / Q000517:prevention & control*; D001863:Bone Screws; D005260:Female; D005360:Fibula / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods; D005594:Fracture Fixation, Intramedullary / Q000379:methods; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012086:Reoperation; D012189:Retrospective Studies; D013978:Tibial Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
keywords: Alignment; Distal tibia fracture; Fibula fixation; Intramedullary nailing