The advantages of interlocking intramedullary fixation of fibula fractures over conventional plating

Introduction: Ankle fractures are among the most common injuries encountered in the emergency department. They affect young and elderly people equally and up to a quarter of them require surgical intervention to restore the ankle joint. For the last 50 years, plate osteosynthesis has been the gold standard for open reduction and internal fixation of fibula fractures. A new alternative to this method is the locked intramedullary fixation with fibula nails. Aim: The purpose of the current paper is to introduce the main advantages of fibula nail fixation over plate fixation in fibula fractures. Methodology: A total of 28 papers relevant to fibular nailing complications were identified using the PubMed search engine. After excluding irrelevant articles, the information was compared to the abundance of information about complications after plate fixation in the literature. Results: Locked intramedullary fixation of fibula fractures appears to be a viable alternative to plate fixation, especially in patients with diabetes mellitus, osteoporosis, and peripheral vascular disease due to significant reduction in the wound complication and reoperation rates. Conclusion: The new generation of fibula nail implants are a valuable tool in the armamentarium of trauma surgeons. Although data is still limited in the literature and further studies are required, this technique provides promising results in the treatment of ankle fractures in the presence of multiple comorbidities or advanced age.