Treatment of ankle fractures with fibular nail: clinical and imaging evaluation

Abstract

Objective: Perform a clinical and imaging evaluation of patients with ankle fractures submitted to osteosynthesis with locked nails.
Methods: Twenty-five patients submitted to surgery using the locked intramedullary nailing technique were selected between April 2018 and December 2022. Patients were over 55 years of age, with an increased risk for healing complications. The American Orthopaedic Foot & Ankle Society (AOFAS) score and visual analog pain (VAS) scale were used for clinical evaluation. The imaging parameters used were the talocrural angle, the medial clear space, and the tibiofibular anterior line. Results: The AOFAS score was evaluated with a mean of 83.48 (± 15.34), a minimum of 40, and a maximum of 98 points. The mean in the VAS scale was 2.56 points (± 2.50), with a minimum of 0 and a maximum of 8. The difference between the mean and the reference value (2 mm) was 0.38 mm in the tibiofibular anterior line. Regarding the medial clear space, 100% presented values within the reference (up to 4 mm). In the talocrural angle, the mean was 80.19 (± 2.93), with a minimum of 73.5 and a maximum of 86.29, within normal values. Conclusion: Osteosynthesis of ankle fractures using locked intramedullary nails seems to be an alternative for older patients at increased risk. Despite not showing a satisfactory reduction in syndesmosis reduction, in most cases, the method showed good functional results in medium-term follow-ups. Level of Evidence II; Therapeutic Studies; Prospectived comparative study.