A Comparative Study of Complication of Distal Both Bone Leg Fractures Treated with Fibula Fixation and Conservative Management for Tibia Vs Fibula Fixation and Operative Management for Tibia

Authors

  • Bivas Bank Senior Resident, MBBS, Master of Surgery in Orthopedics, Department of Orthopedics, Nayagram Multi/Superspeciality Hospital, Jhargram, West Bengal 721159
  • Ashoke Kumar Chanda Associate Professor, MBBS, Diploma and Master of Surgery in Orthopedics, Department of Orthopedics, Calcutta National Medical College and Hospital, Beniapukur, Kolkata 700014
  • Kallol Banerjee Professor of Orthopaedics, MBBS, Diploma and Master of Surgery in Orthopedics, Department of Orthopedics, North Bengal Medical College and Hospital Shusrutnagar, Darjeeling 734012

Abstract

Introduction: Distal both bone leg fractures, involving the tibia and fibula, present a challenge in orthopedic management due to potential complications such as malunion, nonunion, delayed union, and infection. Optimal treatment strategies remain debated, particularly regarding tibial fixation combined with fibular fixation. Aims: To compare the incidence of complications in patients with distal both bone leg fractures treated with fibula fixation combined with conservative management for tibia and fibula fixation combined with operative fixation for tibia. Methods: This was a prospective study conducted at Calcutta National Medical College and Hospital from January 2021 to February 2022, including patients admitted with distal tibia and fibula fractures in the Department of Orthopaedics. A total of 60 patients were enrolled, divided equally into two groups of 30 each. Data were collected on demographic and clinical variables including age, sex, mode of injury, side involvement, comorbidities, AO fracture classification, wound complications, and fracture-related complications. These variables were analyzed to assess outcomes and compare the two groups in terms of operative parameters, postoperative recovery, and complication rates. Results: Among 60 patients, most were aged 21-30 years (35.0%) and male (58.3%), with road traffic accidents being the leading cause of injury (56.7%). AO A1 fractures were most common (50.0%), and side involvement and comorbidities were similar between groups. Most patients had no wound (83.3%) or fracture complications (71.7%), though Group B had slightly more anterior knee pain and wound dehiscence. Group A had shorter operative time (0.48 ± 0.19 vs. 1.50 ± 0.27 hours) but delayed full weight bearing (16.9 ± 1.9 vs. 14.7 ± 1.7 weeks) and fracture union (26.4 ± 2.0 vs. 22.6 ± 3.1 weeks) compared to Group B. Conclusion: Fibula fixation combined with operative management of the tibia offers better fracture alignment, earlier union, and superior functional outcomes compared to conservative tibial management, though at the expense of a higher risk of surgical site complications. Individual patient factors, fracture configuration, and soft tissue condition should guide the choice of treatment modality.

Keywords:

Distal both bone leg fracture, fibula fixation, tibia conservative management, tibia operative management, complications

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Published

2025-09-09
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Vol. 16 No. 9 (2025): Volume16,Issue9

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Articles