From the Research
Surgical intervention for distal fibula fractures is indicated when there is displacement greater than 2mm, ankle joint instability, or significant talar shift, and minimally invasive techniques such as intramedullary fixation or minimally invasive plate osteosynthesis can provide excellent functional results with low complication rates, as shown in a systematic review published in 2021 1. The indications for surgical intervention include:
- Displacement greater than 2mm
- Ankle joint instability
- Significant talar shift
- Weber B and C fractures with displacement
- Bimalleolar or trimalleolar fractures
- Open fractures
- Fractures with soft tissue compromise
- Cases where closed reduction cannot achieve or maintain proper alignment The goal of surgery is to restore anatomic alignment of the ankle mortise, which is crucial for normal joint mechanics and to prevent post-traumatic arthritis. Some key points to consider when deciding on the surgical approach include:
- The use of minimally invasive techniques to reduce wound complications
- The importance of restoring fibular length and rotation
- The need for syndesmotic screws in cases of syndesmotic disruption
- The potential benefits of early surgical intervention in improving functional outcomes and reducing complication rates, as reported in a study published in 2017 2. Post-operative management typically involves 6-8 weeks of protected weight-bearing with progressive rehabilitation to restore ankle function and strength. It is also important to consider the patient's overall health and potential comorbidities, such as diabetes, peripheral vascular disease, or osteoporosis, which can affect the surgical approach and post-operative management, as noted in a study published in 2014 3.