[Operative treatment of ankle fractures-what about biomechanics? : From angle stability to nail fixation]

Ankle fractures in geriatric patients represent a relevant and not yet definitively resolved problem in everyday trauma surgery practice.

Are there biomechanical studies on different osteosynthesis techniques for treatment of the fibula in geriatric ankle fractures, and can the superiority of one method be demonstrated?

The article comprises a systematic literature review on the biomechanics of various osteosynthesis techniques for geriatric ankle fractures.

There are several biomechanical studies on different osteosynthesis techniques. However, only isolated studies are available on additional Kirschner wires, plates with quadrocortical screws, double-plate osteosynthesis, and intramedullary nail fixation. The dorsal antiglide plate has been studied more extensively; however, no advantage over the angular-stable lateral plate could be demonstrated. The strongest body of evidence exists for angular-stable plate osteosynthesis. Nevertheless, a meta-analysis was unable to demonstrate overall superiority, although it suggests a theoretical advantage in osteoporotic bone.

From a biomechanical perspective, the ideal osteosynthesis technique for treatment of the fibula in geriatric ankle fractures has not yet been identified.