This prospective study is done from Oct 2017 to May 2019 having 60 patients, 30 patients with fibula fixation and 30 patients without fibula fixation done in department of orthopaedics of Victoria and Bowring & Lady Curzon hospitals, Bangalore.

These cases were reviewed periodically at 4, 8, 12 weeks and 24 weeks both clinically and radiologically for bony union. Clinical outcome and Radiological criteria (RUST SCORE) regarding fracture union and complications was evaluated and documented. Functional outcome was compared with Johner and Wruhs criteria.

Fixation of fibula in cases of distal third fractures of both bones of leg where tibial fracture is treated by IM nail have better outcomes by significantly reducing tibial malalignment (varus/valgus). Fibula fixation prior to fixation of tibia helps in restoring the height of the lateral column and helps in reduction of the tibia anatomically and also radiological shortening post operatively was less. This may be the reason for less valgus/varus angulation in cases where fibula was fixed.

There is no significant difference in the time of union of the tibial fracture, radiological translation, rate of complications and the functional score between the two groups of patients.