Review Article

The Role of Fibular Fixation in Distal Tibia-Fibula Fractures: A Meta-Analysis

Table 1

The main characteristics of selected studies.

AuthorYearsType of designCaseAverageOpen fracture: closed fractureType of surgeryAverage follow-upAssessment

Francesco et al. [23]2018Prospective cohort studyFibular fixation: 49
No fibular fixation: 38
Fibular fixation: 56.4
No fibular fixation: 59.8
No open fracturesInterlocking intramedullary nail for tibia and plating fixation for fibular18 monthsRotational alignment and valgus/varus and posterior/anterior angulations
Michael et al. [21]2017Retrospective studyFibular fixation: 166
No fibular fixation: 174
Fibular fixation: 166
No fibular fixation: 174
Fibular fixation: 93 : 73
No fibular fixation: 95 : 79
Interlocking intramedullary nail for tibia and plating fixation for fibular21 monthsTime to union, delayed union, and nonunion
Mohammad et al. [22]2017Randomized controlled studyFibular fixation: 24
No fibular fixation: 25
Fibular fixation: 36.9
No fibular fixation: 34.8
No open fracturesInterlocking intramedullary nail for tibia and 3.5 mm DCP fixation for fibula9 monthsValgus/varus and posterior/anterior angulations and nonunion
Benjamin et al. [26]2015Retrospective studyFibular fixation: 15
No fibular fixation: 83
Fibular fixation: 42.8
No fibular fixation: 40.3
Fibular fixation: 1 : 14
No fibular fixation: 30 : 53
Interlocking intramedullary nail for tibia and plating fixation for fibular117 monthsValgus/varus and posterior/anterior angulations and nonunion
Berlusconi et al. [20]2014Retrospective studyFibular fixation: 26
No fibular fixation: 34
Fibular fixation: 47.12
No fibular fixation: 44
Fibular fixation: 9 : 17
No fibular fixation: 10 : 24
Interlocking intramedullary nail for tibia and plating fixation for fibular>6 monthsNonunion
Manish et al. [24]2013Randomized controlled studyFibular fixation: 30
No fibular fixation: 30
NAFibular fixation: 14 : 16
No fibular fixation: 12 : 18
Interlocking intramedullary nail for tibia and 3.5 mm DCP fixation for fibula18 monthsRotational alignment and valgus/varus and posterior/anterior angulations
Rouhani et al. [25]2012Randomized controlled studyFibular fixation: 24
No fibular fixation: 29
Fibular fixation: 24.2
No fibular fixation: 28.6
Fibular fixation: 11 : 13
No fibular fixation: 17 : 12
Interlocking intramedullary nail for tibia and 3.5 mm DCP fixation for fibula6 monthsValgus/varus and posterior/anterior angulations and nonunion

NA, not available.