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Journal of Orthopaedics and Traumatology

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Open Access 01-12-2014 | Review Article

Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes

Authors: Sameer Jain, Benjamin A. Haughton, Christopher Brew

Published in: Journal of Orthopaedics and Traumatology | Issue 4/2014

Abstract

Background

Ankle fractures are extremely common and represent nearly one quarter of all lower-limb fractures. In the majority of patients, fractures involve the distal fibula. The current standard in treating unstable fractures is through open reduction and internal fixation (ORIF) with plates and screws. Due to concerns with potentially devastating wound complications, minimally invasive strategies such as intramedullary fixation have been introduced. This systematic review was performed to evaluate the clinical and functional outcomes of intramedullary fixation of distal fibular fractures using either compression screws or nails.

Materials and methods

Numerous databases (MEDLINE, PubMed, Embase, Google Scholar) were searched, 17 studies consisting of 1,008 patients with distal fibular fractures treated with intramedullary fixation were found.

Results

Mean rate of union was 98.5 %, with functional outcome reported as being good or excellent in up to 91.3 % of patients. Regarding unlocked intramedullary nailing, the mean rate of union was 100 %, with up to 92 % of patients reporting good or excellent functional outcomes. Considering locked intramedullary nailing, the mean rate of union was 98 %, with the majority of patients reporting good or excellent functional outcomes. The mean complication rate across studies was 10.3 %, with issues such as implant-related problems requiring metalwork removal, fibular shortening and metalwork failure predominating.

Conclusion

Overall, intramedullary fixation of unstable distal fibular fractures can give excellent results that are comparable with modern plating techniques. However, as yet, there is unconvincing evidence that it is superior to standard techniques with regards to clinical and functional outcome.

Level of evidence

Level IV evidence.

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Title: Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes
Authors: Sameer Jain
Benjamin A. Haughton
Christopher Brew
Publication date: 01-12-2014
Publisher: Springer International Publishing
Published in: Journal of Orthopaedics and Traumatology / Issue 4/2014
Print ISSN: 1590-9921
Electronic ISSN: 1590-9999
DOI: https://doi.org/10.1007/s10195-014-0320-0

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Intramedullary fixation of distal fibular fractures: a systematic review of clinical and functional outcomes

Abstract

Background

Materials and methods

Results

Conclusion

Level of evidence

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Level of evidence

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