Abstract
The current reference standard for unstable ankle fractures is open reduction and
internal fixation using a plate and lag screws. This approach requires extensive dissection
and wound complications are not uncommon. The use of intramedullary screw fixation
might overcome these issues. The aim of our study was to provide an overview of the
published data regarding intramedullary screw fixation of fibula fractures combined
with a small consecutive case series. We performed a search of published studies to
identify the studies in which fibula fractures were treated with percutaneous intramedullary
screw fixation. Additionally, all consecutive patients treated for an unstable ankle
fracture in a level 1 trauma center using an intramedullary screw were retrospectively
included. The literature search identified 6 studies with a total of 180 patients.
Wound infection was seen in 1 patient (0.6%), anatomic reduction was achieved in 168
patients (93.3%), and a loss of reduction was seen in 2 patients (1.1%). Implant removal
was deemed necessary in 3 patients (1.7%) and nonunion was seen is 2 patients (1.1%).
A total of 11 patients, in whom no wound complications occurred, were included in
our study. The follow-up duration was a minimum of 12 months. A secondary dislocation
was seen in 1 patient, and delayed union was observed after 7.5 months in 1 other
patient. In conclusion, intramedullary screw fixation is a safe and adequate method
to use for fibula fractures, with a low risk of wound complications. Additional research
regarding functional outcome is warranted.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 21, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
