title: The Role of Fibular Fixation in Distal Tibial Fractures.
abstract: BACKGROUND
  Lower tibial extra-articular fractures of lower tibial extra-articular bone, treated with Minimally Invasive Percutaneous plate osteosynthesis (MIPPO) may have certain advantages, though the modiality is technically demanding.
  
  
  OBJECTIVE
  To assess the results of distal tibial fractures treated with minimally invasive plate osteosynthesis utilizing precontoured dital medial tibial locking plates without fibular fracture fixation.
  
  
  METHODS
  The study was conducted during the period from june 2009 to june 2011. A series of 30 patients (22 men and 8 women) with concurrent distal tibia and fibula fractures who underwent minimally plate osteosynthesis utilizing precontoured distal tibial medial locking plates without fibular fracture fixation have been reviewed after surgery. 14 fractures were type A1, 6 type A2, and 4 type A3. Open Grade II fracture were 4 and Open Grade IIIA fracture is2.
  
  
  RESULTS
  The mean follow-up duration was 2 years. The mean time to bone union was 20 weeks. No patient had shortening, hardware breakdown, or deep-seated infection. Out of 30 patients, 24 had excellent results, 6 had good results. Four patients had palpable screws, two patient had blisters which subsidized with conservative treatment. This minimally invasive technique for treatment of distal tibial fractures proved to be a feasible and worthwhile method of stabilization.
  
  
  CONCLUSIONS
  It appears from our study that fibula fixation is not required in non-syndesmotic distal metaphyseal extra articular fractures when fixed by locking plate using minimal invasive techniques.
authors.affiliation: Assistannt Professor, Department of Orthopaedics, SNMC , Bagalkot, Karnataka, India .
authors.forename: Girish H
authors.initials: GH
authors.lastname: Vasanad
authors.affiliation: Professor, Department of Orthopaedics, SNMC , Bagalkot, Karnataka, India .
authors.forename: S M
authors.initials: SM
authors.lastname: Antin
authors.affiliation: Assistannt Professor, Department of Orthopaedics, SNMC , Bagalkot, Karnataka, India .
authors.forename: R C
authors.initials: RC
authors.lastname: Akkimaradi
authors.affiliation: Senior Resident, Department of Orthopaedics, SNMC , Bagalkot, Karnataka, India .
authors.forename: Prasad
authors.initials: P
authors.lastname: Policepatil
authors.affiliation: Assistannt Professor, Department of Orthopaedics, SNMC , Bagalkot, Karnataka, India .
authors.forename: Girish
authors.initials: G
authors.lastname: Naikawadi
keywords: Distal tibial fractures; Fibular fixation; Minimally invasive technique