Minimally Invasive Fixation of a Distal Fibula Fracture With an Intramedullary Nail

Area of Science:

• Orthopedic Surgery
• Traumatology
• Surgical Techniques

Background:

• Intramedullary (IM) nailing for distal fibula fractures offers benefits over lateral plates, including earlier weight-bearing, smaller incisions, and reduced hardware prominence.
• IM nails provide rotational stability and allow for syndesmosis fixation, supported by long-term studies demonstrating clinical viability.

Purpose of the Study:

• To illustrate the use of an IM nail for the fixation of distal fibula fractures through a technique video.
• To highlight the advantages and procedural steps of IM nailing in managing these specific fractures.

Main Methods:

• Percutaneous incisions are utilized for fracture reduction and clamp placement.
• A small incision at the fibular tip serves as the entry point for the IM nail, with K-wire guidance for accurate placement.
• Reaming, guidewire insertion, talon deployment, and interlocking screw fixation are performed, with optional syndesmosis fixation.

Main Results:

• The technique demonstrates a high success rate of 90% for achieving good outcomes.
• Patients typically regain normal driving ability around 9 weeks, with full recovery taking approximately 2 years.

Conclusions:

• IM nailing is a viable option for distal fibula fracture fixation, offering significant advantages.
• Maintaining anatomic reduction and proper nail placement are critical for successful outcomes.