Intramedullary fixation of lateral malleolus using Fibula Rod System in ankle fractures in the elderly

Challagundla, Sudhakar Rao; Shewale, Sandeep; Cree, Calum; Hawkins, Amanda

doi:10.1016/j.fas.2017.04.015

Cited by 26 publications

(29 citation statements)

References 12 publications

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“…12,30 Furthermore, a small case series of four patients found similar success using the same device which gives an unproven but promising trend for its use for open fractures. 26…”

Section: Discussionmentioning

confidence: 99%

Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre

Al-Obaidi

Wiik

Bhattacharyya

et al. 2019

J Orthop Surg (Hong Kong)

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To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a nondesigner centre. Methods: In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Postoperative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications. Three patient reported outcome scores (Olerud and Molander score (OMAS), American Association of Orthopaedic Surgeons (AAOS) foot and ankle score and 12-Item Short Form Survey (SF-12)) were collected to obtain an overall measure of the patient's physical and mental outcome. Results: The adequacy of reduction data was available for 38 of 39 cases; 33 (87%) achieved good, 3 (8%) fair and 2 (5%) poor ratings, based on the McLennan and Ungersma marking system. Thirty-five (12 open and 23 closed) patients were available for initial follow-up. Five (14.3%) of 35 had documented complications (2 of 12 in the open cohort and 3 of 23 in the closed cohort). All fibular fractures treated with the fibular nail went on to unite. Twenty-three (66%) of 35 patients were available at 1-year followup for measurement of objective outcome. The combined mean OMAS for both groups was 53.7 (0-85) with statistically better results (59.5 (25-85) vs. 37.3 (0-75)) in favour of the closed versus open injuries, respectively. The mean AAOS score was also statistically better for the closed group than the open, 70.3 (30-95) versus 46.6 (20-77), respectively. The mean SF-12 score (physical component) was 40 (21.6-52.4) in the closed group versus 36.1 (19.4-51.5) in the open group; the mean mental component was 42.5 (26.6-54.3) in the closed group versus 38.8 (28.4-60.5) in the open group, these however were not statistically different. Conclusion: Fibular nails are an effective alternative for the treatment for both closed and open unstable ankle fractures with soft tissue compromise.

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“…12,30 Furthermore, a small case series of four patients found similar success using the same device which gives an unproven but promising trend for its use for open fractures. 26…”

Section: Discussionmentioning

confidence: 99%

Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre

Al-Obaidi

Wiik

Bhattacharyya

et al. 2019

J Orthop Surg (Hong Kong)

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“…Within 22 publications that investigated fibular nail fixation, this implant was analyzed in 8 studies. 1,3,[6][7][8]11,22,29 The nail is made of titanium and allows secure cross-locking including distal anteroposterior locking screws and lateral to medial trans-implant tibial-fibular syndesmosis screws. This design allows fragment fixation in addition to fibular length and rotational stability.…”

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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“…Fibular intramedullary devices require smaller incisions and have less prominent metal structure while resulting in fewer complications and having a potential for greater mechanical stability. [28][29][30][31][32][33][34] Rajeev et al 12 reported a 100% rate of union in 24 patients, with an average time to union of 8.7 weeks using a fibular intramedullary nail. Asloum et al 15 reported a 100% rate of union in 36 patients treated with intramedullary nail fixation.…”

Section: Discussionmentioning

confidence: 99%

“…9,26,27 Recently, the literature has suggested that intramedullary fibular nail fixation can outperform the conventional fixation plate and screws while using a lessinvasive approach. [28][29][30][31][32][33][34] Although intramedullary fibular nail fixation has been used for more than 25 years, recent design improvements, including an interlocking nail, fibula-specific intramedullary nails, and a hole for syndesmosis screw placement, have led to the emergence of intramedullary nail fixation as a viable alternative approach for treatment of distal fibular fracture. 12,35 Intramedullary nail fixation is often an advantageous choice for patients with poor skin conditions, comorbidities such as diabetes, and very osteoporotic or comminuted bone.…”

Section: Introductionmentioning

confidence: 99%