In addition, a few studies have shown that fibular plate internal fixation can increase the rate of delayed healing and non-healing of tibial fractures. Javdan reported that dynamic compression bone plate (DCP) or tubular plate fixation of fibula had no significant difference in influence on tibial fracture healing, reduction of postoperative complications and recovery of affected limb function.
However, some other studies found that standard open reduction and internal fixation of tibia with intramedullary nail or minimally invasive percutaneous plate osteosynthesis (MIPPO), without the fibula being fixed, had good reduction stability of tibial fracture, reduced the risk of soft tissue injury and infection, and had a good prognosis of function. The results showed that fibula fixation was helpful to restore tibial length, reduce lateral movement of fracture and maintain the stability of the tibia in shaft direction. īonnevialle conducted a prospective cohort study, 126 cases of patients with distal tibia and fibula fractures were treated by fixing tibia with external fixator, intramedullary nail or plates, while fibula is not fixed, or fixed with intramedullary nail or plates. The role of fibular fixation in the treatment of distal tibiofibular syndesmosis injury and pilon fractures has been well defined, however, it is still controversial whether the fracture of fibular needs fixation and which method is selected in extra-articular fractures of the lower leg. Till now it is still a big challenge to treat it because of the wound contamination, limited soft tissue envelope and poor vascularity.
Open fractures of distal tibia associated with fibula are usually caused by high-energy trauma such as traffic accidents or falling from high places. External fixator combined with plate-screw osteosynthesis had no advantage in treating extra-articular open fractures of distal tibia and fibula when compared with simple external fixation. ConclusionĬompared with simple external fixator fixation and external fixator combined with plate-screw osteosynthesis, external fixator combined with K-wire intramedullary fixation shortens the operative time and fracture healing time, reduced costs and complications of fracture healing, while the blood loss, infection complications and ankle function recovery showed no difference with the other two groups. The excellent or good rate of ankle function was 69.70% in group A, 72.41% in group B and 84.00% in group C, with no statistical difference among the three groups ( P > 0.05).
The surgical and implants costs in group C (5.24 ± 1.21, thousand dollars) is lower than that in group A (6.48 ± 1.11, thousand dollars) and group B (9.37 ± 2.16, thousand dollars) ( P 0.05). Resultsįour patients were lost to follow-up, and 87 patients were followed up for 5–35 months (average, 14.2 months). The operation time, intraoperative blood loss, surgical and implants costs, fracture healing time, postoperative complications, and American Orthopaedic Foot and Ankle surgery (AOFAS) scores were compared among the groups. Methodsįrom January 2017 to July 2019, 91 cases of open fractures of distal tibia and fibula were treated with external fixator, and the fibula was fixed with non-fixation (group A, n = 35), plate-screw (group B, n = 30) and Kirschner wire (group C, n = 26). To compare the efficacy of three different fixation methods of fibula combined with external fixation of tibia for the treatment of extra-articular open fractures of distal tibia and fibula.
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