Clin Orthop Surg.  2020 Dec;12(4):529-534. 10.4055/cios19177.

Fibula Fracture: Plate versus Nail Fixation

• Bäcker HC
• Vosseller JT

• KMID: 2508784
• DOI: http://doi.org/10.4055/cios19177

Abstract

Background
Intramedullary fixation has only uncommonly been used in the fibula although it may confer some advantages. Our goal was to investigate a single surgeon’s learning curve with initial usage of an intramedullary device for fibular fixation based on surgical time and quality of reduction.
Methods
Prior to initiation of this study, an experienced ankle fracture surgeon performed fibular nail fixation in a sawbones and a cadaver setting. Between February and August 2018, all patients who suffered from a distal fibula fracture underwent fibula fixation (n = 20) using the Fibulock (Arthrex). Patients were retrospectively investigated and compared with a control of fibular plate fixation. The tourniquet time, time of anesthesia, and surgery time were recorded as well as the quality of reduction.
Results
In the 20 cases, the mean tourniquet time was 68.9 ± 23.2 minutes for nail fixation, while in the fibular plate fixation group, the mean time was 75.8 ± 23.9 minutes (p = 0.37). Two patients had slight malreductions (first and third cases): one was corrected with a lag screw outside the nail, the other was an elderly patient with significant blistering in whom an entirely percutaneous reduction was performed.
Conclusions
Intramedullary fixation for fibular fractures does not appear to have a significant learning curve for an experienced ankle fracture surgeon.

Keyword

Intramedullary; Nail; Rod; Fibula; Fracture; Learning curve