Locked retrograde fibula nail for the surgical treatment of unstable ankle fractures

OBJECTIVE: Minimally invasive surgical stabilization of ankle fractures allowing postoperative full weight bearing. INDICATIONS: Unstable ankle fractures type Weber B and C in the geriatric patients or with a critical soft tissue situation. CONTRAINDICATIONS: Ankle fractures in young patients and patients with high demands (relative contraindication). SURGICAL TECHNIQUE: Closed reduction, retrograde insertion of the intramedullary nail into the fibula via a small incision, insertion of up to four locking screws using an aiming device and small incisions. POSTOPERATIVE MANAGEMENT: Full weight bearing in an ankle joint orthosis. RESULTS: In 34 patients who were treated with a retrograde fibula nail, a 6-month follow-up was possible in 18 patients. Osseous consolidation was achieved without any soft tissue complications or infections in all 18 cases. The patients regained their preoperative level of mobility (Parker Mobility Score 4.2 preoperative vs 4.3 postoperative).