Repair of Distal Fibula Fractures with Minimally Invasive Intramedullary Nailing in the Elderly.

Abstract

Ankle fractures have been well documented and are common, especially in the elderly, behind hip and distal radius fractures. Open reduction and internal fixation (ORIF) is the standard of treatment for displaced and unstable ankle fractures. Traditionally, ankle fractures in the elderly population have been treated with nonoperative methods; however, nonoperative methods have been associated with increased mortality. Thus, there has been a shift toward operative management for the elderly and less healthy patients. However, these patients often present with more comorbidities that make them not ideal candidates for ORIF of the fracture. Minimally invasive intramedullary nailing of the fibula has gained popularity in recent years for the treatment of displaced ankle fractures. A 72-year-old man presented to the clinic with left ankle pain with a duration of 2 weeks. Radiography revealed a displaced fracture of the left fibula at the level of the ankle joint. This case report documents the surgical treatment of a displaced distal fibula fracture using minimally invasive intramedullary nailing of the fibula. At 4 months' follow-up, the patient was walking with minimal assistance and weightbearing as tolerated. Left untreated, displaced ankle fractures can be very debilitating, with increased mortality and morbidity, especially in the elderly population. Thus, early diagnosis and surgical treatment of displaced ankle fractures are imperative. The purpose of this report was to raise awareness of minimally invasive fibular nailing as an alternative to ORIF in the treatment of displaced ankle fractures in the elderly.