Nailing the fibula: alternative or standard treatment for lateral malleolar fracture fixation? A broken paradigm

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Vincenzo GiordanoPeter V Giannoudis

Abstract

Despite the fact that open reduction and internal fixation with a plate, either non-locked or locked, is the standard of care for managing lateral malleolus fractures, intramedullary (IM) fixation of the fibula has been recently introduced as an alternative, mainly for some potential complicated situations. We hypothesized that almost all patterns of distal fibula fracture can be safely fixed with an IM device, with the potential benefit of providing biomechanical efficiency, but using a soft-tissue friendly implant. Here, we present a multicenter case series based on a proposed algorithm. Sixty-nine consecutive patients were managed with fibular IM fixation for closed malleolar fractures. Twenty patients were managed by IM screw fixation and 49 by fibular nailing. Outcome was measured both according to the American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle and hindfoot, and the time to bone union. The mean AOFAS for Group I was 99.35 ± 1.95 points and that for Group II was 89.30 ± 16.98 points. There were no significant differences between the fracture pattern, according to the Lauge-Hansen classification, and post-operative levels of pain and functional activity among patients in both groups (p > 0.05). All f...Continue Reading

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Citations

Jun 20, 2020·Revista do Colégio Brasileiro de Cirurgiões·Vincenzo GiordanoHilton Augusto Koch
Mar 16, 2021·Journal of Clinical Orthopaedics and Trauma·Rachel M FaberJoshua L Langford

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