Background: This study investigates the impact of fibula fixation in conjunction with intramedullary tibial nailing on functional recovery in distal third leg fractures, focusing on the escalating road traffic injuries in India. Material and method: Eighty patients aged 18-70 were divided into groups with and without fibula fixation, assessing outcomes through the RUST SCORE, Johner and Wruhs criteria, and the Ankle-Evaluation Rating System. Result: Predominantly right-sided and closed fractures were observed, with both groups experiencing valgus angulation, albeit lower in patients with fibular fixation. Union was achieved within 12 months, with a slightly prolonged duration in fibula fixation cases. Fibula fixation demonstrated marginal advantages in ankle range of motion and function at six months. The study underscores the need to consider individual patient factors, contributing vital insights to the ongoing discourse on distal tibia and fibula fracture management, prompting further research and consensus-building.