A prospective comparative study of distal tibia and fibula fractures treated with tibial interlocking nailing with and without fibular plating

Background: Distal both bone leg fractures present significant challenges in orthopedic surgery. The purpose of this study was to evaluate the functional and radiological outcomes of tibial interlocking nailing alone versus interlocking nail with supplementary fibular plating. Methods: A hospital-based, prospective interventional study was conducted on 72 patients, divided into two groups. Karlstrom-Olerud scoring and radiographic assessment were used to evaluate outcomes. SPSS software will be used for all statistical calculations. Results: Patients in the interlocking nail with fibular plating group demonstrated improved alignment values in varus/valgus angulation (p=0.00008) and anteroposterior angulation (p=0.00029), also Karlstrom Olerud score was significantly better in fibular plating group at 3 months (p=0.002). There was slightly earlier union time in fibular plating group than patients without fibular plating (14.86 and 15.55 respectively) and also there was higher rate of patients requiring secondary procedures in group without fibular plating (6) compared to group with fibular plating (2). Conclusion: Patients with fibular plating group demonstrated significantly improved alignment and functional scores, suggesting that supplementary fibular plating enhances stability and reduces malalignment.