The Role of Fibular Fixation in Distal Tibia-Fibula Fractures:A Meta-Analysis

-e necessity of fibular fixation in distal tibia-fibula fractures remains controversial. -is study aimed to assess itsimpact on radiographic outcomes as well as rates of nonunio‎n and infection.Methods. A systematic search of the electronicdatabases of PubMed, Embase, and Cochrane library was performed to identify studies comparing the outcomes of reduction andinternal fixation of the tibia with or without fibular fixation. Radiographic outcomes included malalignment and malrotation ofthe tibial shaft. Data regarding varus/valgus angulation, anterior/posterior angulation, internal/external rotation deformity, andthe rates of nonunio‎n and infection were extracted and then polled. A meta-analysis was performed using the random-effectsmodel for heterogeneity.Results. Additional fibular fixation was statistically associated with a decreased rate of rotation deformity(OR�0.13; 95% CI 0.02–0.82,p�0.03). However, there was no difference in the rate of malreduction between the trial group andthe control group (OR�0.86; 95% CI 0.27–2.74,p�0.80). -ere was also no difference in radiographic outcomes of varus-valgusdeformity rate (OR�0.17; 95% CI 0.03–1.00,p�0.05) or anterior-posterior deformity rate (OR�0.76; 95% CI 0.02–36.91,p�0.89) between the two groups. Meanwhile, statistical analysis showed no significant difference in the nonunio‎n rate(OR�0.62; 95% CI 0.37–1.02,p�0.06) or the infection rate (OR�0.81; 95% CI 0.18–3.67,p�0.78) between the two groups.Conclusions. Additional fibular fixation does not appear to reduce the rate of varus-valgus deformity, anterior-posterior deformity,or malreduction. Meanwhile, it does not appear to impair the unio‎n process or increase the odds of infection. However, additionalfibular fixation was associated with decreased odds of rotation deformity compared to controls.