Intramedullary Fixation for Fractures of the Distal Fibula

Walton, David M.; Adams, Samuel B.; Parekh, Selene G.

doi:10.1177/1071100715622392

Cited by 24 publications

(18 citation statements)

References 18 publications

(30 reference statements)

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“…However, in summary, the overwhelming majority of the literature looking at fibula nailing, particularly in comparison with plating, supports lower rates of complications and higher rates of union even with older nail designs. 1–24 In particular, the 3 randomized controlled trials available comparing the treatment of unstable ankle fractures with a fibula nail versus plate have demonstrated similar functional results with lower complication rates and less need for implant removal. 7,8,25…”

Section: Discussionmentioning

confidence: 99%

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fleites

Hodgkins

2022

Journal of Orthopaedic Trauma

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Objectives:To evaluate the treatment of unstable lateral malleolar fractures using a fibula nail with both proximal and distal locking capabilities.Design:Retrospective review of 110 single-surgeon consecutive fibula nails.Setting:Single-surgeon, private practice community hospital.Patients/Participants:One hundred ten fractures, 92 OTA/AO 44B and 18 OTA/AO 44C.Intervention:FibuLock fibula nail (Arthrex, Naples, FL).Main Outcome Measurements:Demographic, operative, clinical, and radiographic outcome data.Results:One hundred two patients/102 fractures met criteria. Ninety percent had a f/u of ≥12 months (mean 12.2 months). All fractures healed. There were no superficial or deep infections, no nonunions, or malunions. Two fractures required conversion to plate fixation intraoperatively because of excessive comminution which precluded the use of a nail, while one patient sustained an iatrogenic superficial peroneal nerve neuroma. No patients reported implant irritation, and none have required implant removal.Conclusion:Fibula nails with proximal locking capabilities offer an alternative to plating with the potential for lower complication rates and lower need for implant removal.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fleites

Hodgkins

2022

Journal of Orthopaedic Trauma

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“…[16][17][18][19][20][21][22] Modern IM nail implants, such as the FibuLock Ankle Pin (Arthrex, Naples, FL) and the Acumed Fibula Rod System (Acumed, Hillsboro, Oregon), build on prior designs by allowing secure cross-locking of fracture fragments, thereby maintaining tibiotalar congruence, as well as, fibular length and rotation. 23,24 The FibuLock Ankle Pin has the additional advantage of proximal fixation via "triangulation talons" and a distal compression slot and screw that provide up to 2.5 mm of compression. 24,25 (Figure 1).…”

Section: Introductionmentioning

confidence: 99%

“…23,24 The FibuLock Ankle Pin has the additional advantage of proximal fixation via "triangulation talons" and a distal compression slot and screw that provide up to 2.5 mm of compression. 24,25 (Figure 1). Despite promising results, there is a paucity of literature describing the outcomes of modern IM nails in comparison with lateral plating.…”

Section: Introductionmentioning

confidence: 99%

The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation

Tracey

Vovos

Arora

et al. 2018

Foot & Ankle Specialist

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Background. Lateral malleolus (LM) fixation is necessary for unstable ankle fractures. Traditional fixation relies on the use of plates through a lateral incision, wound healing can be an issue for such incisions. A novel intramedullary (IM) fixation device has been developed that can be placed through a minimal incision. The purpose of this study was to demonstrate the clinical efficacy of this device. Methods. A retrospective analysis was performed on patients who received IM fixation for isolated fibula, bimalleolar (BM), and trimalleolar (TM) fractures. Pertinent demographic information, operative factors, complications, and clinical outcomes were recorded. Results. Sixteen patients were included in the study with an average age of 59 years (range 35-86 years). Six patients presented with isolated LM fractures, four patients had a BM fracture with a syndesmotic injury, 2 patients sustained a LM fracture with an associated syndesmotic injury, 2 patients had a BM fracture, and 2 patients had a TM fracture with a syndesmotic injury. There was a 100% healing rate of the lateral malleolus without any cases of malunion or shortening. There were no cases of sural nerve or peroneal tendon injuries, nor any wound complications found. Conclusion. These findings demonstrate the safe and efficacious use of a novel intramedullary fixation device for fibula fractures with lower wound complications compared with published outcomes found with lateral fibular plating. The features of this device allow for reliable fixation of the fibula, maintaining length and minimizing wound issues. Levels of Evidence: Level IV: Case series

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“…Numerous studies have revealed the biomechanical and clinical advantages of intramedullary fibular fixation. Systematic reviews of intramedullary fibular fixation for distal fibular fractures have outlined benefits such as a lower risk of complications, faster healing, accelerated rehabilitation, and shorter hospital stays [ 26 , 27 , 28 ]. In a cadaveric biomechanical study, modern fibular rods demonstrated less external rotation stiffness while maintaining syndesmotic diastasis in AO/OTA 44C 2 ankle fractures [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Retrograde Intramedullary Kirschner Wire Fixation as an Alternative for Treating Distal Fibular Shaft Fractures Combined with Distal Tibial Pilon Fractures

Huang

et al. 2022

JPM

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Treatment or management techniques for pilon fractures are associated with high complication rates and poor outcomes. No consensus exists regarding the optimal surgical option for pilon fractures, especially for pilon fractures combined with distal fibular fractures. Accordingly, we explored the use of fibular fixation for treating pilon fractures involving distal fibular shaft fractures. We hypothesized that retrograde intramedullary Kirschner wire (K-wire) fixation is a suitable alternative technique for distal fibular fixation. We retrospectively reviewed the data of 156 patients who underwent surgery for pilon fractures at our hospital from May 2013 to May 2021. The radiographic and functional outcomes were comparable between the fibular intramedullary nailing (Group A; n = 80) and the fibular plating (Group B; n = 76) groups. Groups A and B differed significantly in total hospitalization time (11.4 vs. 18.2 days, p = 0.024), length of postoperative admission (6.8 vs. 11.4 days, p = 0.012), and total admission cost (USD 3624 vs. USD 6145, p = 0.004). We also noted that poor Olerud and Molander ankle scores were significantly associated with age (p = 0.008), smoking (p = 0.012), and preoperative admission length (p = 0.018). Retrograde intramedullary K-wire fixation produced a comparable 12-month functional outcome to plate fixation for distal fibular shaft fractures, rendering it a viable alternative method based on soft tissue condition.

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Intramedullary Fixation for Fractures of the Distal Fibula

Abstract: Level of Evidence: Level V, expert opinion.

Cited by 24 publications

References 18 publications

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

The Use of Modern Intramedullary Nailing in Distal Fibula Fracture Fixation

Retrograde Intramedullary Kirschner Wire Fixation as an Alternative for Treating Distal Fibular Shaft Fractures Combined with Distal Tibial Pilon Fractures

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