Operative fixation of fractures of the lateral malleolus may be complicated by skin complications and wound infection, especially in patients with an unfavorable skin condition or soft-tissue injury. The goal of this study was to assess a technique of minimally invasive, proximally inserted plate fixation for distal fibular fractures in unfavorable skin conditions, including superficial abrasions, blisters, and contusions.
This prospective case series study included 20 patients with syndesmotic and suprasyndesmotic fractures of the distal fibula, with unfavorable skin conditions, presenting to the emergency department of a major trauma center between May, 2015 and May, 2016. All patients were followed for an average of 1 yr (range, 6 mo-2 yr).
All fractures united at an average of 9.4 wk (range, 8-12 wk). Functional assessment according to the American Orthopaedic Foot And Ankle Society Scoring system was 93.9 (range, 78-100). None of the cases was complicated by wound dehiscence or deep infection.
Minimally invasive, proximally inserted plate fixation is a viable and safe technique that can avoid an incision over the skin of the distal fibula in patients with unfavorable skin conditions.
Cairo University, Cairo, Egypt
Financial Disclosure: The authors report no conflicts of interest.
Correspondence to Sherif Hamdy Zawam, MSc, Assistant Lecturer, Faculty of Medicine, Cairo University, Cairo, Egypt Tel: +00201004103862; fax: +002-0223786608; e-mail: Sherifzawam@gmail.com.