Radiological Healing and Patient Reported Outcome Scores in Operatively Treated Weber B Fibula Fractures with and without Lag Screw Fixation

Research Type: Level 3 - Retrospective cohort study, Case-control study, Meta-analysis of Level 3 studies Introduction/Purpose: There are limited clinical studies applying the concept of fibula fracture fixation without the use of lag screws. The aim of this retrospective study is to compare the clinical and radiological outcomes of the plate and lag screw (PS) versus the plate alone (PA) techniques applied to the distal fibula. Methods: A consecutive series of patients who underwent distal fibula ORIF utilizing either PS or PA technique for distal fibula fractures were retrospectively analyzed. Patient postoperative imaging was evaluated for callus as proxy for primary versus secondary bone healing. Patient reported outcomes were assessed utilizing the PROMIS-PF/PI scoring system. Radiologic outcome measures were evaluated postoperatively. Results: Preliminary data demonstrated distal fibula callus formation in 3 (n=10, 30%) of the PS group compared to 7 (n=20, 35%) for the PA group. Mean PROMIS PF/PI scores were 39/47.5 in PS and 47.5/51.1 in PA groups (p=0.42/0.75). The tibiofibular overlap, talar tilt, lateral and medial clear space, and talocrural angle were equivalent in both groups. Conclusion: In this retrospective single-center consecutive series there was no benefit utilizing the PS over the PA technique for distal fibula ORIF with respect to primary bone healing, overall complication rate, or patient reported outcomes.