Distal Fibula Pro-Tibial Screws in Salvage Fixation of Bimalleolar Ankle Fractures – A Novel Technique

Document Type : CASE REPORT

Authors

1 Orthopaedic Department, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom

2 Dept of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland, UK

3 Department of Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom

10.22038/abjs.2024.76119.3515

Abstract

Here we present a novel adaptation of the previously described fibula pro-tibial fixation in a case requiring salvage fixation of a bimalleolar ankle fracture in an osteoporotic patient. Unstable osteoporotic ankle fractures are a challenging injury to manage and typically occur in a frail and comorbid subgroup of patients. Various techniques have been described in the evolution of managing these injuries, e.g. hindfoot nailing and anatomical locking plates, however in this uniquely challenging case a novel strategy was required to mitigate bone loss in the distal fibular fracture fragment. There is some evidence to suggest fibular protibial fixation offers a lower complication profile to its alternatives. The novel use of distal fibula pro-tibial screws offers a new alternative to hindfoot nailing of bimalleolar ankle fracture in osteoporotic bone with compromised distal fibular fragment bone purchase. Further research is required to investigate the compatibility of this technique with early weightbearing.

Keywords: Ankle, Osteoporosis, Bone Failure, Salvage fixation, Revision fixation

Level of Evidence: Level IV

Keywords

Main Subjects

The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 03 March 2024

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History

  • Receive Date: 08 November 2023
  • Revise Date: 28 April 2024
  • Accept Date: 07 January 2024

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