Fracture fixation of both bone lower third leg using minimally invasive plate osteosynthesis technique - is fixation of fibula necessary


  • Chaitanya Krishna Department of Orthopaedics, Medical College and Hospital, Kolkata, West Bengal
  • Jayanta Mondal Department of Orthopaedics, Medical College and Hospital, Kolkata, West Bengal



Mippo technique, Distal third tibia and fibula, Fibula fixation, Distal tibial locking plate


Background:Fractures of the distal third tibia and fibula can be challenging to treat because of the limited soft tissue, the subcutaneous location and poor vascularity. The best treatment remains   controversial. Specific objectives of this study are mal-alignment in coronal and sagittal plane, rotational deformity and function stability of the ankle joint after fixation of tibia, and to determine the need for fixation of fibula.

Methods: Distal third tibia and fibula fracture were included in the study. Tibia fracture was fixed with distal tibial locking plate using MIPPO Technique. Fibula was fixed in one group using one third tubular plate, consisting of 20 patients and in other group fibula was not fixed which also consist of 20 patients.

Results:In the entire series average valgus angulation in group where fibula was not fixed was 9.6 degree and malrotation was 16.05, while in group where fibula was fixed had valgus angle 5.95 and malrotation angle 7.5.

Conclusions:Fibula fixation is better than without fixation of fibula. Patients with additional fibular stabilization had proper realignment of ankle mortise resulting in less restriction of ankle movement and better functional outcome. . In patients where both tibia and fibula is fixed there is reduced malunion, ankle stiffness, ankle pain and improves functional outcome.






Original Research Articles