Abstract
Introduction
Fixation of the distal fibula in conjunction with ankle fractures has not changed over the last 50 years. The complication rate of these fixation techniques is as high as 30%. The fibula nail is an alternative method of fixation and uses a minimal invasive technique. This technique preserves soft tissue compared to previous techniques used, and fewer soft tissue complications.
Method
We reviewed the preliminary results of 178 patients with unstable Weber B and C ankle fractures that were operated on in our unit between January 2012 and February 2013. We used the Acumed fibular nail for reduction and fixation of the lateral malleolus. Using the nail we had significant reduction in our operating time. Patients were discharged one day post operation without any POP and partial weight bearing on crutches. Various parameters were measured on all the follow- up x-rays and assessed for incongruencies compared with the normal ankle. These parameters were medial clearspace, talo-crural angle, talar tilt and fibular length. No patients thus far have had any loss of fixation. The Olerud and Molander score was used at three month and six month follow up.
Results
Patients at three months scored an average of 80 and at six months an average of 85. There were no cases of non-union. 40 patients had systemic co-morbidities. We had four superficial wound complications that healed well with antibiotics and daily wound care.
Conclusion
The fibula nail is an effective fixation technique for most Weber B and C ankle fractures. It causes minimal destruction of the soft tissue. Functional outcome of patients is excellent.
NO DISCLOSURES
