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Objective: Evaluate Effect of dynamic hindfoot valgus deformity following intramedullary xation of tibia and conservatively managed proximal and middle 1/3rd bular fractures on ankle function Retrospective study The study involve Design: Materials and methods : d 20 patients who had undergone conservative management for proximal to middle one-third (except distal one-third level) bular fracture and who had unilateral middle and distal one-third tibial fractures treated by anatomic reduction and interlocking intramedullary nail xation. The Outcome Measures: Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Foot and Ankle Disability Index Score were used to calculate functional outcome ratings for each patient. In addition, Mean Length of bula and Mean hindfoot valgus was observed. 20 patients were studied The mean Results: KOOS score was 86.5, and the mean FADI score was 89.4. [8,9] The statistical difference in FADI and KOOS in cases of operated side and the contralateral side were statistically insignicant leading to the conclusion that the occurrence of the hindfoot valgus angulation does not cause any functional impairment of the ankle. The increase in calcaneal valgus on the clinical hindfoot examination was a mean of 6 compared to that of the other extremity. Fibular shortening was identied in 14 cases and mean bular shortening was found to be 1.1 cm. Dynamic hindfoot Conclusions: valgus deformity is a foreseen complication in cases of distal diaphyseal fractures of tibia treated with intramedullary nailing along with conservatively managed concurrent proximal and middle third bular fractures. This deformity is predominantly seen in cases where bular shortening occurs but its effect on the ankle function is almost unhindered.

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