Cannulated Intramedullary Screw Fixation of Distal Fibular Fractures

Ebraheim, Nabil A.; Maten, Josh W. Vander; Delaney, Joshua R; White, Erik; Hanna, Maged; Liu, Jiayong

doi:10.1177/1938640018790082

Cited by 13 publications

(8 citation statements)

References 40 publications

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“…22,29 In the majority of cases, the union rate was 100%, with 2 exceptions, which found a union rate of 97.4% 8 and 97.8%. 9 The complication rates reported varied between 0% 28 and 47%. 7 Quality of reduction was only investigated in 3 studies (2 case series and 1 comparative study).…”

Section: Historical Considerationsmentioning

confidence: 99%

Fibular Nail Fixation: Topical Review

Bäcker

2019

Foot Ankle Int.

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Background: Intramedullary implants have been used historically in long bone fractures with success. In recent years, a variety of intramedullary implants for the treatment of fibular fractures have been investigated. These various implants have not been assessed together in a cohesive manner. In this review, we assess implants used for intramedullary fixation of fibular fractures with respect to implant design and clinical results. Methods: A comprehensive systematic literature review for intramedullary implants in fibular fractures was performed. All publications that assessed intramedullary fibular implants were reviewed. In total, 11 different intramedullary nails were found. Clinical results obtained from these studies were reviewed. Results: The intramedullary implants used for fibular fracture fixation generally fell into one of 3 categories: an unlocked longitudinal strut, an implant roughly equivalent to a large screw, or a more traditionally locked intramedullary nail. Reported clinical results were generally good, although inconsistent outcome reporting greatly limited comparison between studies. Complication rates varied with the implants but were generally low. Conclusion: Intramedullary implants for fibular fracture stabilization have changed over the years to improve stability. Although clinical results are limited, data suggest that these implants are safe and can potentially approximate more traditional implants. Level of Evidence: Level II, systematic review.

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Section: Historical Considerationsmentioning

confidence: 99%

Fibular Nail Fixation: Topical Review

Bäcker

2019

Foot Ankle Int.

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“…All eight studies were retrospective case series. 4e9, 34,35 None of these studies compared the screw to a plate and screw construct.…”

Section: Resultsmentioning

confidence: 99%

Intramedullary fixation of fibula fractures: A systematic review

Bäcker

2021

Journal of Clinical Orthopaedics and Trauma

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Introduction: Distal fibula fractures are common injuries that often require open reduction internal fixation. Intramedullary fixation of the fibula has been used historically, and interest has been renewed somewhat recently, although there is limited data assessing outcomes after intramedullary fibular fixation. The purpose of this study was to systematically evaluate the literature as it relates to the clinical and functional outcome after fibular fracture fixation using an intramedullary device. Methods: A literature review on Medline/Pubmed, EMBASE, Cochrane and Google was performed. In total, 1994 abstracts were reviewed of which 30 articles in English, German and French were included, all of which evaluated the clinical and functional outcome after fibular nail osteosynthesis. Results: Within the 30 studies, a total of 1116/1380 patients were treated with a fibular nail between 1986 and 2018. In total 11 different devices were investigated. Six articles compared fibular nail versus plate osteosynthesis and in five cases a prospective study was performed. The complication rate varied somewhat widely based on the implants used. The mean union rate was 99.1% with a mean follow-up of 19.0 months. In comparison to plate fixation the nail was superior in terms of complication rate in most studies. No unified assessment of functional outcome was used, and so comparison between studies was difficult. However, good and excellent results were obtained in 73%e100% of patients. Conclusion: Current data on intramedullary fixation of the fibula is limited and suffers significantly from inconsistency in outcome reporting. It remains to be seen whether the potential advantages of intramedullary implants can both maintain the good results of other implants and improve on some aspects of more commonly used implants.

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“…Increased risk of complications from infection, delayed union, and nonunion in patients with comorbidities must be considered while deciding to implement this form of treatment. 17 Six to eight weeks of immobilization and non-weight-bearing are typically required before a second operation is needed to remove the syndesmosis screw. During this time, there is a risk of recurrence of the diastasis and fracture of the screw due to force.…”

Section: Treatment Of Syndesmosis Injurymentioning

confidence: 99%

Management of Syndesmosis Injury: A Narrative Review

Liu¹,

Valentine²,

Ebraheim³

2022

ORR

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The syndesmosis is an important fibrous joint that plays a crucial role in normal ankle weight-bearing and movements. Syndesmosis injuries include disruption of one or more of the ligaments comprising the distal tibiofibular syndesmosis and are commonly associated with ankle fractures. The treatment of grade 1 syndesmosis injury should be conservative, such as immobilization for one to three weeks followed by gradual return to activity. For the treatment of grade 2 syndesmosis injury, if it was stable enough, the patients still could be managed with conservative therapies. But majority of them strongly favor surgical treatment. For the treatment of grade 3 syndesmosis injury, it should treat with surgical reconstruction. If syndesmosis injury is associated with ankle fractures, surgical reduction, fixation, and reconstruction are usually required. Common surgical treatment methods include syndesmosis screws, composed of either metallic or bioabsorbable material; fibula intramedullary nails; and dynamic button-suture fixation, TightRope or ZipTight. Each method has advantages and disadvantages which must be considered while determining which treatment will provide the best outcomes depending on the patient’s needs. Continued exploration of new materials, devices, and methods for surgical fixation is necessary for advancement in this field.

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Cannulated Intramedullary Screw Fixation of Distal Fibular Fractures

Abstract: Level IV: Retrospective, case series.

Cited by 13 publications

References 40 publications

Fibular Nail Fixation: Topical Review

Fibular Nail Fixation: Topical Review

Intramedullary fixation of fibula fractures: A systematic review

Management of Syndesmosis Injury: A Narrative Review

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