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Updated: Jan 24, 2026

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Lag Screw-Only Fixation for Simple Oblique Fibular Fractures: A Narrative Review.

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Lag screw-only fixation shows promise for simple distal fibula fractures, achieving high union rates and comparable outcomes to traditional plating. However, more research is needed to confirm its safety and efficacy for early rehabilitation.

Keywords:
ankle fracturefibulafracture fixationlag screwmalleolar fractures

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Area of Science:

  • Orthopedic Surgery
  • Traumatology
  • Biomechanical Engineering

Background:

  • Lag screw-only fixation is a less invasive surgical option for simple oblique distal fibula fractures.
  • It aims to reduce hardware complications compared to traditional plate fixation.
  • This review evaluates its stability and complication profile.

Purpose of the Study:

  • To assess the efficacy of lag screw-only fixation for simple oblique distal fibular fractures.
  • To compare its outcomes with traditional plating methods.
  • To identify potential benefits and limitations.

Main Methods:

  • A narrative literature review was performed using PubMed, Embase, and Cochrane Library.
  • Included studies reported clinical or biomechanical outcomes of lag screw-only fixation.
  • Relevant biomechanical studies and editorials were also reviewed.

Main Results:

  • Eight clinical and six biomechanical studies were analyzed, primarily involving Lauge-Hansen SER-type fractures.
  • Lag screw-only fixation demonstrated 100% union rates with excellent functional outcomes (OM, FAAM, SANE scores).
  • Complication rates were low, and biomechanical models indicated stability comparable to plating.

Conclusions:

  • Lag screw-only fixation is a potentially viable option for select distal fibular fractures.
  • Current evidence is limited and heterogeneous, necessitating further investigation.
  • More research is required to validate its safety for early rehabilitation protocols.