Journal of Musculoskeletal Trauma

Original Articles

The effects of the fibular stabilization in the treatment of distal tibio-fibula fracture: Kyung Jin Song, Gyu Hyung Kim, Myung Sik Park, Byung Yun Hwang; J Korean Soc Fract 2001;14(4):660-667. Published online October 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.4.660

Abstract PDF: PURPOSE
The purpose of this study was to analyze the effect of fibula stabilization on reduction and union time of tibial fracture, and change in ankle mortise in the treatment of distal tibiofibular fracture.
MATERIALS AND METHODS
We reviewed 23 cases with distal tibiofibula fracture; 10 cases were stabilized and 13 cases were not stabilized for the fibula fracture with reduction and stabilization for the tibia fracture. We analyzed the initial and last follow-up radiograph, and clinical functional outcome.
RESULTS
There were significant differences in the tibiofibular clear space and tibiofibular overlap between two groups and there were somewhat significant differences in the union time of the tibial fracture and ROM of ankle and pain of fracture site or ankle between two groups. But there were no significant differences in talo-crural angle and gap of tibial fracture site between two groups. Moreover, such factors as initial displacement, soft tissue damage, comminution of fracture were affected the union time and prognosis of a tibial fractures.
CONCLUSION
Fibular stabilization group was effective in the maintenance of ankle mortise but there was no difference in the functional outcome. Analysis for much more cases and long term follow-up will be necessary for the precise evaluation of the treatment results.

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The Posterior Plate for Distal Fibular Fixation: Beak Yong Song, Ho Yoon Kwak, Sang Wook Bae, Kyung Tai Lee, Nam Hong Choi, Jin Young Kim, Ho Jun Kim; J Korean Soc Fract 2001;14(1):79-84. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.79

Abstract PDF: PURPOSE
To evaluate the clinical results between the posterior and lateral plate for distal fibular fixation in the bimalleolar, trimalleolar fracture and isolated lateral malleolar fractures with more than 3 mm of displacement.
MATERIALS AND METHODS
We reviewed 69 cases treated by open reduction and internal fixation with the posterior or lateral plate for distal fibular fractures in the bimalleolar, trimalleolar fractures and isolated lateral malleolar fractures with more than 3mm of displacement. The follow up period was more than 12 months.
RESULTS
In the posterior plate group, radiographically there were no intraarticular screw, loss of fixation, nonunion and malunion, but 2 cases of distal tibiofibular synostosis were developed. In physical examination, there were no wound complication, palpable screws, peroneal tendinitis and limitation of motion, but 2 patients who had distal tibiofibular synostosis complained of mild discomfort after walking.
CONCLUSION
The posterior plate for distal fibular fixation is thought to be a favorable method and can be recommended as the fixation modality of choice regardless of level of fracture, because of increased biomechanical stability and few complication.

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Effects of Fibular Fixation for Interlocking Nailing of Distal Tibiofibular Fractures: Sang Ho Moon, Phil Hyun Chung, Chung Soo Hwang, Dong Ju Chae, Beom Kim; J Korean Soc Fract 2000;13(2):296-302. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.296

Abstract PDF: PURPOSE
: To compare redioiogic results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures.
MATERIALS AND METHODS
: From April 1993 to February 1999, 26 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 61 fractures fixed with nails only. Average age of patients was 41.8 years. These two groups were compared by frequency of malalignment, degree of postoperative angulation, angulation according to comminution, angulation according to fracture configuration. The statistical analysis was evaluated by t-test.
RESULTS
: Fibular fixation group had no malalignment while non-fixations had angulation of 1.2+/-1.1 degree and non-fixation had 3.0+/-2.1. So fixation had lessor angulation than non-fixation significantly(p=0.004). In lateral rediographs, each had 1.3+/- 1.1, 2.8+/-2.3 degree and showed significant difference(p=0.027). In type I and II fractures of Winquist-Hansen classification, fixation group showed lesser degree of angulation in A-P plane significantly(p=0.008) but no significant difference in lateral plane. In type III and IV, no significant difference in both planes. According to configuration of fractures, transverse and spiral fractures showed no significant differences but oblique configurations had significant differences in A-P plane(p=0.002) CONCLUSION : Interlocking intramedullary nail with fibular fixation has the advantage in maintenance of alignment during insertion of nail in distal tibiofibular fractures, especially in Winquist-Hansen classification type I and II and oblique fractures in anteroposterior plane, so it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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