OBJECTIVETo compare and evaluate clinical effects between locking intramedullary nail fixation and skeletal traction in order to provide the best therapeutic choice for tibiofibula fractures.

METHODSFrom November 1989 to December 2000, 108 patients with tibiofibula fractures (group A) were treated with skeletal traction, there was 76 males and 32 females; the age was from 29 to 66 years with an average of (40.3 +/- 9.6) years; according to AO classification standard,48 cases were type A, 46 type B, 14 type C, of which the standard typing Gustio, type I in 15 cases, type II in 13, type III A in 2. And from January 2001 to July 2007, 57 patients with tibiofibula fractures (group B) were treated with locking intramedullary nail fixation,there was 40 males and 17 females,the age was from 21 to 69 years with an average of (38.1 +/- 8.9) years; according to AO classification standard, 27 cases were type A, 22 type B, 8 type C, of which the standard typing Gustio, type I in 7 cases, type II in 6, type III A in 1. Four indexes were compared, including the time of fracture healing, the time of achieved 90 degrees genuflection, the time of off-bed weight-bearing and complication.

RESULTSComparison of fracture healing time: group A was (19.0 +/- 0.6) weeks and group B was (14.0 +/- 0.5) weeks; the time of achieved 90 degrees genuflection in group A was (92.0 +/- 8.2) d and in group B was (39.0 +/- 6.1) d; the time of off-bed weight-bearing in group A was (96.0 +/- 6.3) d and in group B was (38.0 +/- 6.5) d. Complication occurred in 42 cases in group A and 6 in group B. There was significantly difference in 4 items between two groups (P < 0.01). The method of locking intramedullary nail fixation was better than skeletal traction in treating tibiofibula fractures.

CONCLUSIONTreatment of tibiaofibula fractures with locking intramedullary nail fixation can obtain satisfactory effect, which has less complication, the fracture heals and weigh-loading can be achieved early.