A New Technique for Complex Fibula Fracture Fixation in the Elderly: A Clinical and Biomechanical Evaluation

Kenneth J. Koval, Douglas M. Petraco, Frederick J. Kummer, Srino Bharam

Research output: Contribution to journalArticlepeer-review

61 Scopus citations

Abstract

Objective: To determine whether intramedullary fixation could augment plate fixation strength in comminuted and osteopenic fibula fractures. Study Design: Retrospective clinical study and biomechanical laboratory study. Methods: Twenty comminuted or osteopenic fibula tractures in twenty patients age fifty years or older were stabilized using plate fixation augmented with intramedullary Kirschner wires. Nineteen patients were available for follow-up which averaged 15.4 months (range, 6-43 months). In conjunction with this clinical series, a biomechanical evaluation was performed comparing fixation of mildly osteopenic fibulas using this technique to plate and screws alone. The fibulas were first tested non destructively in bending, and then destructively in torsion to determine stability and ultimate strength of the fixation. Results: All nineteen fractures united without loss of reduction: seventeen of nineteen patients (89%) had either no pain slight or mild pain. Biomechanical testing demonstrated that the resistance to bending of the plated fibulas augmented with Kirschner wires was 81% greater than the fibulas stabilized with a plate alone (p<.05). In torsional testing, the augmented group had twice the resistance to motion than the plate group (p<.002). Conclusion: This clinical series and biomechanical study support the use of plate fixation augmented with intramedullary Kirschner wires for the treatment of comminuted and osteopenic fibula fractures in the elderly.

Original languageEnglish
Pages (from-to)28-33
Number of pages6
JournalJournal of Orthopaedic Trauma
Volume11
Issue number1
DOIs
StatePublished - Jan 1997
Externally publishedYes

Keywords

  • Biomechanical
  • Clinical
  • Fibula fracture
  • Internal fixation

Fingerprint

Dive into the research topics of 'A New Technique for Complex Fibula Fracture Fixation in the Elderly: A Clinical and Biomechanical Evaluation'. Together they form a unique fingerprint.

Cite this