Complications With Intramedullary Nailing of Fibula Fractures With Open Reduction: A Prospective Study

Area of Science:

• Orthopedic surgery
• Traumatology

Background:

• Ankle fractures are common intra-articular fractures.
• Open reduction and internal fixation via a lateral approach is standard for unstable fractures.
• Intramedullary fibular nail fixation is increasingly used for distal fibula fractures to minimize soft-tissue damage.

Purpose of the Study:

• To evaluate the outcomes and complication rates of ankle fracture patients treated with fibular nail fixation.
• To assess the efficacy of fibular nailing when combined with open reduction.

Main Methods:

• A prospective cohort study included 61 consecutive patients with ankle fractures treated using a fibular nail.
• Open reduction of the fibula fracture was performed in 54 patients (88.5%) via a 3-5 cm incision.
• Follow-up was conducted for a median of 15.9 months.

Main Results:

• The overall complication rate was 24.6%, with fibular fixation/lateral approach complications at 16.4%.
• Minor infection and hardware removal were the most frequent complications (8.2% each).
• Deep infections occurred in 3.3% of patients, and malreduction in 1.6%.

Conclusions:

• The current data suggest that the benefits of fibular nailing are limited when open reduction is employed.
• Further investigation is warranted to compare fibular nail fixation outcomes with percutaneous versus open reduction techniques.