Does fibula fracture have an impact on tibial healing?

Abstract

Aim: Tibial diaphysis fractures are frequently-encountered fractures of the lower extremities. Fibula fracture may accompany these fractures. In this study, we investigated the effects of accompanying fibula fracture on the healing of tibial diaphysis fractures, which were treated by intramedullary nail fixation. Materials and Methods: Data of the patients who presented to our clinic and underwent intramedullary nailing for tibial diaphysis fractures between January 2016 and December 2018 were reviewed. Patients were divided into two groups based on the presence (Group 1) or absence (Group 2) of accompanying fibula fracture. Database which included information such as fracture type (open or closed fracture), fracture healing time, angulation, and smoking history were retrospectively analyzed. The effect of accompanying fibula fracture and other parameters on the healing time following intramedullary nail fixation of tibia diaphysis fractures was investigated. The Shapiro-Wilk, the Mann-Whitney U, and the Chi-Square tests were used for statistical analysis. Results: One hundred twenty-eight patients were included in this study. Among these patients, 101 had accompanying fibula fracture while 27 had intact fibula. Fracture healing times were significantly shorter in the latter group (p=0.001). However, there was no statistically significant difference between the groups in terms of fracture angulation except for valgus angulation. Smoking history and the presence of open or closed fracture did not have a significant impact on outcomes (p=0.249). Discussion: Intact fibula shortens the healing time after intramedullary nail fixation of tibia diaphysis fracture.