Minimally Invasive Surgical Approach to Distal Fibula Fractures: A Technique Tip

Document Type : TECHNICAL NOTE

Authors

1 Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, USA

2 Orthopedic Surgeon, Harvard Medical School, BIDMC, Carl J. Shapiro Department of Orthopaedics, Boston, USA

3 Department of Orthopaedic Surgery, Harvard Medical School, Division of Foot and Ankle Surgery, BIDMC, Department of Orthopaedic Surgery, BIDMC, Boston, USA

Abstract

 
Wound complications following ankle fracture surgery are a major concern. Through the use of minimally invasive surgical techniques some of these complications can be mitigated. Recent investigations have reported on percutaneous fixation of distal fibula fractures demonstrating similar radiographic and functional outcomes to traditional open approaches. The purpose of this manuscript is to describe in detail the minimally invasive surgical approach for distal fibula fractures.

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Main Subjects


1. Nåsell H, Ottosson C, Törnqvist H, Lindé J, Ponzer S. The
impact of smoking on complications after operatively
treated ankle fractures--a follow-up study of 906
patients. J Orthop Trauma. 2011; 25(12):748-55.
2. Wukich DK, Lowery NJ, McMillen RL, Frykberg RG.
Postoperative infection rates in foot and ankle surgery:
a comparison of patients with and without diabetes
mellitus. J Bone Joint Surg Am. 2010; 92(2):287-95.
3. Miller AG, Margules A, Raikin SM. Risk factors for
wound complications after ankle fracture surgery. J
Bone Joint Surg Am. 2012; 94(22):2047-52.
4. Ovaska MT, Mäkinen TJ, Madanat R, Huotari K,
Vahlberg T, Hirvensalo E, et al. Risk factors for deep
surgical site infection following operative treatment
of ankle fractures. J Bone Joint Surg Am. 2013;
95(4):348-53.
5. Chien B, Hofmann K, Ghorbanhoseini M, Zurakowski 
D, Rodriguez EK, Appleton P, et al. Relationship of
self-reported ability to weight-bear immediately after
injury as predictor of stability for ankle fractures.
Foot Ankle Int. 2016; 37(9):983-8.
6. Hess F, Sommer C. Minimally invasive plate
osteosynthesis of the distal fibula with the locking
compression plate: first experience of 20 cases. J
Orthop Trauma. 2011; 25(2):110-5.
7. Hoffer MM. Percutaneous lateral malleolar transtibial
pin fixation of unstable ankle fractures. J Trauma.
1976; 16(5):374-6.
8. Carlile GS, Giles NC. Surgical technique for minimally
invasive fibula fracture fixation. Foot Ankle Surg.
2011; 17(3):119-23.
9. Kong C, Kolla L, Wing K, Younger AS. Arthroscopyassisted
closed reduction and percutaneous nail fixation
of unstable ankle fractures: description of a minimally invasive procedure. Arthrosc Tech. 2014; 3(1):e181-4.
10. Iacobellis C, Chemello C, Zornetta A, Aldegheri R.
Minimally invasive plate osteosynthesis in type B
fibular fractures versus open surgery. Musculoskelet
Surg. 2013; 97(3):229-35.
11. Pires RE, Mauffrey C, de Andrade MA, Figueiredo
LB, Giordano V, Belloti JC, et al. Minimally invasive
percutaneous plate osteosynthesis for ankle fractures:
a prospective observational cohort study. Eur J Orthop
Surg Traumatol. 2014; 24(7):1297-303.
12. Chiang CC, Tzeng YH, Lin CC, Huang CK, Chang MC.
Minimally invasive versus open distal fibular plating
for AO/OTA 44-B ankle fractures. Foot Ankle Int.
2016; 37(6):611-9.
13. Chaudhary SB, Liporace FA, Gandhi A, Donley BG,
Pinzur MS, Lin SS. Complications of ankle fracture in
patients with diabetes. J Am Acad Orthop Surg. 2008;16(3):159-70.
14. Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P,
Tscherne H. Minimally invasive plate osteosynthesis
and vascularity: preliminary results of a cadaver
injection study. Injury. 1997; 28(Suppl 1):A7-12.
15. Farouk O, Krettek C, Miclau T, Schandelmaier P, Guy P,
Tscherne H. Minimally invasive plate osteosynthesis:
does percutaneous plating disrupt femoral blood
supply less than the traditional technique? J Orthop
Trauma. 1999; 13(6):401-6.
16. Helfet DL, Suk M. Minimally invasive percutaneous
plate osteosynthesis of fractures of the distal tibia.
Instr Course Lect. 2003; 53(2):471-5.
17. Ray TD, Nimityongskul P, Anderson LD. Percutaneous
intramedullary fixation of lateral malleolus fractures:
technique and report of early results. J Trauma. 1994;
36(5):669-75.