Abstract
Our objective is to describe the technique of intramedullary (IM) nailing of lateral malleolus in the surgical management of ankle fractures. Fracture reduction is performed either percutaneously with a small pointed reduction clamp in simple oblique fractures or using longitudinal traction and rotation for comminuted fractures, thus reducing complications related to open reduction and internal fixation with a plate. The technique has been shown to be simple and reproducible. In addition, the technique allows early weight bearing, which accelerates rehabilitation and potentially fasten fracture healing. IM nailing is a viable option for the fixation of the of lateral malleolus in ankle fractures and should be considered in the surgeon's armamentarium.
Highlights
Intramedullary (IM) nailing of the lateral malleolus has been used with increasing frequency for stabilization of malleolar fractures[1,2]
Recent studies have shown that fibular nailing allows secure fixation of ankle fractures, with the majority of patients reporting good to excellent outcomes, a mean union rate of 98%, and a significantly lower rate of soft tissue complications compared to open reduction and internal fixation (ORIF)[1,3,4,5]
Cadaveric studies have demonstrated that fibular nail is biomechanically comparable to distal fibular locking plate and has greater torque to failure compared to nonlocking plate in non-comminuted lateral malleolar fractures[6,7]
Summary
Vincenzo Giordano[1 ], Peter V Giannoudis[2], Guilherme Boni[3], Robinson Esteves Pires[4], Junji Miller Fukuyama[5], Alexandre Leme Godoy-Santos[6], Hilton Augusto Koch[7]
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