The Operative Treatment of Ankle Fractures: A 10-Year Retrospective Study of 1529 Patients

Use of Fibula Nails With Proximal and Distal Fixation

“…However, interestingly, fibula nailing still had equivocal results to plating techniques, many even showing improved results when nailing over plating. 3 , 7 , 8 , 18 Rush rods, Ender nails, and Knowles pins are earlier intramedullary devices that were effective at aligning the fibula, but did not provide good rotational or axial stability. 4 We believe that a nail that provides both distal and proximal fixation is essential for rotational stability and length control.…”

“…Traditionally, operative treatment of unstable ankle fractures has been open reduction and internal fixation (ORIF). 1 , 2 , 6 , 7 ORIF is performed to reduce the fracture anatomically under direct visualization, and plate fixation is the favored method to treat fibula fractures. 1 , 3 , 6 However, plate fixation may require extensile incisions through the skin and overlying soft tissue, elevation and stripping of adjacent musculature, periosteum, and blood supply.…”

“… 1 , 3 , 16 Extensile incisions potentially require delayed surgical intervention because of soft tissue swelling, which increases the risk of wound healing complications. 7 Larger incisions may also increase postoperative pain and therefore need for more narcotics, increased postoperative swelling, and larger cosmetic scarring. 8 Additionally, the presence of a plate on the surface of the subcutaneous distal fibula may cause irritation and require removal, with an average removal rate reported at approximately 34.7% (12%-95.5%).…”

What Is the Rate of Displacement of Occult Posterior Malleolus Fractures in Nailed Tibial Shaft Fractures?

“…However, the size of these slightly displaced PMFs (average size of 26% of articular surface) compares favorably with the size and orientation of small PMF present in rotational ankle injuries, which are also frequently not formally reduced or fixed and generally have acceptable outcomes when the ankle mortise is otherwise stable. [22][23][24] Of note, most of these fractures were assessed using radiographs alone, which likely underestimate the size of articular involvement compared with CT, 13,25 so these results should be reviewed in light of that limitation. In addition, because of variability in practice patterns between the emergency department staff, general surgery trauma team, and orthopaedic team, there were some preoperative CTs performed in patients without obvious fractures, indicating some heterogeneity in the decision to obtain a preoperative CT.…”

Distal Fibular Metastasis of Colorectal Carcinoma: A Case Report

“…The differential diagnosis for ankle pain is broad and includes lateral ankle sprain and fibula fracture, two of the most common orthopedic injuries in urgent care settings. [1][2][3][4] In contrast, both primary and secondary tumors rarely occur near the ankle. Only 2.5% of all primary bone tumors are found in the fibula.…”