[Objective]To compare the clinical efficacy of open reduction and internal fixation for tibiofibular fractures with or without fixation of the fibular fracture.[Methods]A retrospective analysis was conducted on 54 patients who received surgical treatment for tibiofib-ular fractures in the Department of Traumatic Orthopedic,Ruikang Hospital,Guangxi University of Traditional Chinese Medicine from Janu-ary 2018 to January 2020.Based on preoperative communication between doctors and patients,29 patients had tibial fracture fixed,com-bined with fibular fracture fixed simultaneously(the fixed group),while other 25 patients had the tibial fracture fixed only,without fixation of the fibular fracture(the non-fixed group).The perioperative,follow-up,and imaging data were compared between two groups.[Results]All the patients in both cohorts had the surgical procedures successfully completed without any related complications during the operation.Al-though the fixed group had significantly longer surgical time[(112.4±13.3)min vs(81.0±11.2)min,P＜0.001]and total incision length[(7.0±1.3)cm vs(4.9±1.2)cm,P＜0.001]than the non-fixed group,the former had significantly fewer intraoperative fluoroscopy times[(3.0±0.9)times vs(5.1±1.4)times,P＜0.001]and resumed postoperative walking significantly earlier than the latter[(8.4±1.4)days vs(24.9±3.0)days,P＜0.001].All patients in both cohorts were followed up for a period of 12～18 months,and the fixed cohort resumed full weight-bearing activ-ity significantly earlier than the unfixed group[(22.1±1.3)weeks vs(23.4±1.0)weeks,P＜0.001].Compared with those 3 months after surgery,both groups showed significant improvements in VAS,HSS,AOFAS scores,and ankle dorsal flexion-plantar flexion range of motion(ROM)(P＜0.05)at the last follow-up.The fixed cohort proved significantly superior to the non-fixed counterpart in terms of VAS[(0.2±0.3)vs(1.3±0.8),P＜0.001],HSS[(88.8±0.7)vs(87.3±2.1),P＜0.001],AOFAS[(91.3±6.6)vs(79.7±14.0),P＜0.001],knee extension-flexion ROM[(134.9±5.5)° vs(126.2±6.1)°,P＜0.001],and ankle ROM[(58.1±8.4)° vs(44.2±10.4)°,P＜0.001]at the latest interview.Regarding imaging,the fixed group also was significantly better than the non-fixed group in excellent rate of fracture reduction and the imaging fracture healing time(P＜0.05).[Conclusion]In openreduction and internal fixation of tibiofibular double fractures,fixing the fibular fracture yields better clinical outcomes,and is a feasible method.
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