Canton G, Sborgia A, Maritan G, Fattori R, Roman F, Tomic M, Morandi MM, Murena L. Fibula fractures management. World J Orthop 2021; 12(5): 254-269 [PMID: 34055584 DOI: 10.5312/wjo.v12.i5.254]
Corresponding Author of This Article
Gianluca Canton, MD, Associate Professor, Department of Medical, Surgical and Life Sciences, Orthopaedics and Traumatology Unit, Trieste University, 447 Strada di Fiume, Trieste 34149, Italy. gcanton@units.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. May 18, 2021; 12(5): 254-269 Published online May 18, 2021. doi: 10.5312/wjo.v12.i5.254
Fibula fractures management
Gianluca Canton, Andrea Sborgia, Guido Maritan, Roberto Fattori, Federico Roman, Marko Tomic, Massimo Max Morandi, Luigi Murena
Gianluca Canton, Andrea Sborgia, Guido Maritan, Roberto Fattori, Federico Roman, Marko Tomic, Luigi Murena, Department of Medical, Surgical and Life Sciences, Orthopaedics and Traumatology Unit, Trieste University, Trieste 34149, Italy
Massimo Max Morandi, Department of Orthopaedic Surgery, Louisiana State University Health Science Center, Shreveport, LA 71103, United States
Author contributions: Canton G designed the structure of the overall manuscript, authored and drafted text in all sections and finally reviewed the manuscript; Sborgia A contributed to the conception and design of the manuscript and drafted and wrote text in all sections; Maritan G, Fattori R and Tomic M contributed to drafting and writing text in different sections; Roman F collected clinical cases and processed images and tables; Murena L and Morandi MM contributed to the supervision and final validation of the manuscript; All authors have read and approved the final manuscript.
Conflict-of-interest statement: Each of the authors declare no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Gianluca Canton, MD, Associate Professor, Department of Medical, Surgical and Life Sciences, Orthopaedics and Traumatology Unit, Trieste University, 447 Strada di Fiume, Trieste 34149, Italy. gcanton@units.it
Received: October 31, 2020 Peer-review started: October 31, 2020 First decision: January 18, 2021 Revised: February 1, 2021 Accepted: April 5, 2021 Article in press: April 5, 2021 Published online: May 18, 2021
Abstract
Isolated distal fibula fractures represent the majority of ankle fractures. These fractures are often the result of a low-energy trauma with external rotation and supination mechanism. Diagnosis is based on clinical signs and radiographic exam. Stress X-rays have a role in detecting associated mortise instability. Management depends on fracture type, displacement and associated ankle instability. For simple, minimally displaced fractures without ankle instability, conservative treatment leads to excellent results. Conservative treatment must also be considered in overaged unhealthy patients, even in unstable fractures. Surgical treatment is indicated when fracture or ankle instability are present, with several techniques described. Outcome is excellent in most cases. Complications regarding wound healing are frequent, especially with plate fixation, whereas other complications are uncommon.
Core Tip: Isolated fibula fractures are very common injuries. Diagnostic exams must rule out ankle instability. Surgical treatment must be considered in the case of associated ankle instability. Risk factors for wound related complications must be considered when choosing the surgical technique.
