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

Introduction: Distal fractures of both tibia and fibula are common lower limb injuries that can result in significant functional impairment if not appropriately managed. While operative fixation of the tibia is standard in displaced fractures, conservative management remains an option in select cases. The role of fibula fixation in influencing tibial alignment and functional outcomes remains under debate. Aims: This study aims to compare the functional outcomes of distal both bone leg fractures treated with fibula fixation combined with conservative management of tibia versus fibula fixation with operative fixation of the tibia. Methods: This prospective study was conducted at Calcutta National Medical College and Hospital from January 2021 to February 2022, including 60 adults (30 per group) with distal tibia and fibula fractures. Data on demographics, injury characteristics, fracture type, co-morbidities, and complications were collected. Group A received fibula fixation with conservative tibial management, while Group B had fibula fixation with operative tibial management. Functional outcomes, weight-bearing times, fracture union, and complications were assessed to compare the two treatment approaches. Result: Among 60 patients, most were young adults (21–30 years, 35%) and males (58.3%), with road traffic accidents (56.7%) as the leading cause. AO type A1 fractures were most common (50%). Group A had a slightly higher mean age (41.8 ± 13.7 vs. 35.8 ± 11.0 years, p = 0.0681). Operative time was shorter in Group A (0.48 ± 0.19 vs. 1.50 ± 0.27 hours, p < 0.0001). Partial weight bearing was similar (≈5 weeks), but full weight bearing (16.9 ± 1.9 vs. 14.7 ± 1.7 weeks, p < 0.0001) and fracture union (26.4 ± 2.0 vs. 22.6 ± 3.1 weeks, p < 0.0001) occurred earlier in Group B. Functional outcomes improved over time in both groups, with no significant differences at 6 months (63.5 ± 10.10 vs. 68.0 ± 9.70, p = 0.0837) or 9 months (78.33 ± 13.79 vs. 83.0 ± 10.80, p = 0.1499). Conclusion: Fibula fixation combined with operative fixation of the tibia provides superior functional outcomes, earlier union, and better alignment in distal both bone leg fractures compared to fibula fixation with conservative management of tibia. Conservative management may be considered only in selected cases with minimal displacement, but operative tibial fixation remains the preferred approach to optimize functional recovery and reduce complications.