Osteoporotic Distal Fibula Fractures in the Elderly: How To Fix Them.

Arnab Sain,Hemant Bansal,Vijay Sharma,Sitender Garg,Umesh K Meena

doi:10.7759/cureus.6552

Abstract

Osteoporotic fractures of the distal fibula in elderly patients is a challenge to manage. Non-operative management has a poor outcome so operative management is preferred. There are a variety of options for operative management such as locked plate systems, anti-glide plate construct, dual plating constructs, fibula nail, plate with tibial pro-fibular screws, and injectable bone cement (polymethylmethacrylate (PMMA), calcium phosphate). However, no clear guidelines exist for the operative management of osteoporotic distal fibula fractures. The surgeon should detect osteoporotic fractures early to make the best use of resources and avoid complications such as implant failure.

Highlights

Osteoporosis is a systemic disease in which there is a deterioration of the microarchitecture of bone and the bone mass is low, which leads to the risk of fractures secondary to low-energy mechanisms
This article will focus on operative management in osteoporotic distal fibula fractures, as they pose a greater challenge to manage than medial malleolus fractures
This technique provided stable fixation for osteoporotic ankle fractures in elderly patients until the union was achieved with good functional outcomes [29]

Summary

Introduction

Osteoporosis is a systemic disease in which there is a deterioration of the microarchitecture of bone and the bone mass is low, which leads to the risk of fractures secondary to low-energy mechanisms. Fragility fractures of the ankle are increasing in incidence in the elderly population, especially among women [1,2,3]. The most common deformity seen in failed ankle fractures is lateral malleolus shortening and external rotation [4]. Non-operative management of ankle fractures has a high incidence of nonunion and malunion [5,6,7]. Better functional outcomes are seen with the operative treatment of ankle fractures in elderly patients [8,9]. This article will focus on operative management in osteoporotic distal fibula fractures, as they pose a greater challenge to manage than medial malleolus fractures

Methods of operative fixation

Conclusions

Disclosures

Litchfield JC

Findings

34. Larsson S