• Ajay Krishan, Chetan Peshin, and Dara Singh.
• Department of Orthopaedics, GMC Jammu, India.
• J Orthop Surg (Hong Kong). 2009 Dec 1; 17 (3): 317-20.

PurposeTo assess the results of concurrent intramedullary nailing plus plate osteosynthesis for fractures of the distal tibia and fibula.Methods15 men and 10 women (mean age, 35 years) with concurrent fractures of the distal tibia and fibula underwent intramedullary nailing (for the tibia) and plate osteosynthesis (for the fibula). 17 fractures were type A1, 6 type A2, and 2 type A3. Compound type IIIB or more extensive fractures were excluded.ResultsThe mean follow-up duration was 2 years. The mean time to bone union was 20 weeks. Six patients underwent dynamisation and 4 bone grafting. Two patients had malalignment (angulation of >5 degrees in any plane), but none was rotational. No patient had shortening, hardware breakdown, or deep-seated infection. Two patients had superficial cellulitis at the site of the distal locking screws.ConclusionConcurrent intramedullary nailing and plate osteosynthesis for fractures of the distal tibia and fibula is effective in preventing malalignment. Plate osteosynthesis for the fibula provides additional stability even when a single distal locking bolt is used to fix the intramedullary nail to the tibia.

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