Isolated Avulsion Fracture of the Fibular Head: A New Fixation Technique Using a Suture Anchor

Presentation and options in management of avulsion fracture fibular head: A prospective study of rare entity

“…In other 7 patients study, mean age was 41 years and there were 5 male; 2 female. The mechanisms of injury were a collision with players in baseball, a fall from a 2-m height, and 5 traffic accidents 9 .In our experience, severity of injury; from undisplaced fracture fibular head to complete avulsion with injury to ligaments as well as peroneal nerve, was appreciated on clinical presentation and physical examination of the patients (Table) which were later confirmed by 3D CT/MRI evaluation. Bone bruises on the anteromedial condyle of the femur and tibia, meniscus or/and, cruciate ligaments injury are common associated findings in such type of injury 4 .…”

“…In our study grade I posterior and anterior cruciate ligament instability was observed in 2 patients. In a study, 6 patients among 7, who underwent anterior cruciate ligament reconstruction; lachman and pivot shift tests were less than grade II and of 7 patients, 5 showed grade I and II on varus stress tests 9 . No lateral instability was noted in other report 15 and in our cases.…”

“…One patient was followed up to 6 month after operation and the others had been followed up for 2 year (mean 21 months). It was, mean 24 month in a study of seven patients 9 . In our study grade I posterior and anterior cruciate ligament instability was observed in 2 patients.…”

“…The integrity of the posterolateral corner in each patient was confirmed intraoperatively. Various surgical methods of fixation for these fractures have been reported [9,14,15] , however; there is still no standard treatment modality. Our one case had avulsion of fibular styloid that was fixed with stainless steel and K wire.…”

“…In our study in one patient, avulsed fragment was fixed with one suture anchor and in other case it was with 2 of 3.5 mm in size to achieve rigid fixation. There are few studies, among a study of seven cases having similar injuries; they used a bioabsorbable screw-type suture anchor for fixation 9 . Such fixation can deduce the soft tissue dissection, because fewer traumas, provide prees-fit fixation; makes it stable on the cortical bone, and with no need surgery to remove it 16 .…”