Fibula Nail versus Locking Plate Fixation-A Biomechanical Study.

Area of Science:

• Orthopedic surgery
• Biomechanics
• Traumatology

Background:

• Open reduction and internal fixation for ankle fractures can lead to wound healing complications.
• Minimally invasive nail stabilization presents an alternative surgical approach.

Purpose of the Study:

• To biomechanically compare nail stabilization with traditional locking plate fixation for ankle fractures.
• To evaluate range of motion, diastasis, and rotational stiffness of both fixation methods.

Main Methods:

• Eight pairs of geriatric ankle specimens were tested for native stability.
• Unstable ankle fractures were created and fixed with either a locking plate or a nail.
• Biomechanical properties including range of motion, diastasis, and rotational stiffness were measured.

Main Results:

• Both nail and plate fixations resulted in significantly reduced stability and rotational stiffness compared to native ankles (p < 0.001).
• No significant differences were found between nail and plate fixation in range of motion (p = 0.694) and diastasis (p = 0.166).
• Nail fixation demonstrated significantly greater rotational stiffness than plate fixation (p = 0.001).

Conclusions:

• Nail and plate fixation methods offer comparable biomechanical properties for ankle fractures.
• Both fixation methods yield inferior stability compared to native ankle joints.
• Early weight-bearing after nail fixation requires careful consideration of fracture severity.