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

Document Type : CASE REPORT

Authors

Aberdeen Royal Infirmary, Aberdeen, United Kindom

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.
 Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 12, Issue 5
May 2024
Pages 361-364

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History

  • Receive Date: 08 November 2023
  • Revise Date: 29 April 2024
  • Accept Date: 07 January 2024

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