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Updated: Jan 12, 2026
Treatment with Locking Intramedullary Nailing for Intertrochanteric Fracture of the Femur Utilizing a New Awl with a Distal Positioner
Published on: June 6, 2025
Complications With Intramedullary Nailing of Fibula Fractures With Open Reduction: A Prospective Study
Stephanie E Dal Porto-Kujanpaa1, Ramez Sakkab1, Samantha R Spierling Bagsic2
1*Scripps Mercy Hospital, San Diego, CA.
Background:
Ankle fractures represent the most common type of intra-articular fracture. The standard treatment for unstable ankle fractures is open reduction and internal fixation through a lateral approach. Recently, intramedullary nail fixation has become popular for distal fibula fractures to limit soft-tissue damage.
Methods:
A prospective cohort study was conducted of 61 consecutive ankle fracture patients treated with a fibular nail.
Results:
The median follow-up time was 15.9 months (interquartile range, 13.6-23.2 months). Open reduction of the fibula fracture with an incision measuring between 3 and 5 cm was performed on 54 patients (88.5%). The overall complication rate was 24.6%. The complication rate of fibular fixation or lateral approach was 16.4%. The most common complications were minor infection (8.2%) and hardware removal (8.2%). Two deep infections (3.3%) occurred. Malreduction occurred at a rate of 1.6% (n = 1). Relevant comorbidities included diabetes (14.8%), renal disease (3.3%), and current or former smoking (24.5%). There were no statistically significant associations between patient demographics (age, body mass index, sex, smoking status, diabetes) and complications.
Conclusions:
Given the complication rate, our data suggest that the benefit of fibular nailing is limited when open reduction is used. Further study comparing fibular nail fixation with percutaneous versus open reduction is warranted.
