Percutaneous Intramedullary Screw Fixation of Distal Fibula Fractures: A Case Series and Systematic Review.
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.
['Loukachov|Vladimir V|VV|', 'Birnie|Merel F N|MFN|', 'Dingemans|Siem A|SA|', 'de Jong|Vincent M|VM|', 'Schepers|Tim|T|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D064386:Ankle Fractures D001863:Bone Screws D015331:Cohort Studies D005260:Female D005360:Fibula D005594:Fracture Fixation, Intramedullary D017102:Fracture Healing D050723:Fractures, Bone D006801:Humans D007593:Joint Instability D008297:Male D008875:Middle Aged D011379:Prognosis D016059:Range of Motion, Articular
ankle fracture wound complications complication rate intramedullary devices