Distal tibial extra-articular fractures are often a
result of complex high-energy trauma, which commonly
involves associated fibular fractures and soft tissue injury.
The goal of tibial fixation is to maximise fracture stability
without increasing soft tissue morbidity from surgical
intervention. The role of adjunctive fibular fixation in distal
tibial metaphyseal fractures has been controversial;
although fibular fixation has been shown to improve stability
of distal tibial fractures, there has been increased
potential for soft tissue-related complications and a delay
to tibial fracture healing. Adjunctive fixation of concomitant fibular fractures without associated syndesmotic or
ankle pathology is not necessary in surgically stabilised
extra-articular metaphyseal fractures of the distal tibia.
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