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Related Concept Videos

Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Related Experiment Video

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An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
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Comparison of Ankle Fracture Fixation Using Intramedullary Fibular Nailing Versus Plate Fixation.

Calvin J Rushing1

  • 1Dallas Orthopedic and Shoulder Institute, Sunnyvale, TX.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|June 2, 2024
PubMed
Summary

Intramedullary fibular (IMF) nails offer advantages for ankle fracture fixation over traditional plates/screws (PS), including reduced pain and complications. This study supports IMF nails as a viable alternative for ankle fracture treatment.

Keywords:
ankle fracturefibular nailintramedullary fixationplates/screwssyndesmotic injurytrauma

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Area of Science:

  • Orthopedic surgery
  • Traumatology
  • Biomaterials engineering

Background:

  • Ankle fractures are common injuries requiring surgical fixation.
  • Traditional plates/screws (PS) fixation can lead to complications like hardware irritation and delayed healing.
  • Intramedullary fibular (IMF) nails present a potential alternative with reported benefits.

Purpose of the Study:

  • To compare the clinical and radiographic outcomes of ankle fracture fixation using intramedullary fibular (IMF) nails versus plates/screws (PS) constructs.
  • To evaluate differences in pain, time to union, complications, and reoperations between the two fixation methods.

Main Methods:

  • Retrospective cohort study of 61 ankle fractures (30 IMF, 31 PS) treated between May 2020 and May 2022.
  • Patients were followed for at least 1 year postoperatively with standardized weightbearing protocols.
  • Demographic, clinical, and serial radiographic data were collected and analyzed.

Main Results:

  • The IMF nail cohort reported less pain and fewer complications (23% vs. 45%) compared to the PS cohort.
  • Faster time to union was observed in the IMF group (11.4 weeks vs. 13.2 weeks), though not statistically significant.
  • Symptomatic hardware irritation was significantly higher in the PS cohort (p =< .001).
  • Tobacco use was associated with adverse osseous healing and increased complications.

Conclusions:

  • Intramedullary fibular (IMF) nailing is a viable alternative to traditional plates/screws (PS) fixation for ankle fractures.
  • IMF nails may lead to improved patient outcomes, including reduced pain and complications.
  • Further research may be warranted to achieve statistical significance in observed outcome differences.