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Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
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Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
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Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
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Journal Article
Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
2025
Overview
Background
Interest in less invasive surgeries for Weber type B distal fibular fracture has increased recently. This study aimed to demonstrate that nitinol staple-only fixation is less invasive compared to antiglide plate fixation.
Materials and methods
This retrospective review involved 59 patients with Weber type B fibular fractures who underwent surgery between 2018 and 2023. Twenty-eight patients underwent antiglide plate fixation, whereas 31 underwent multiple nitinol staple-only fixation. The intraoperative assessment included skin incision length and operative time. The radiographic outcomes were bone union and fibular length. The clinical outcomes included delayed wound healing, infection, discomfort from the implant, implant removal, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) score administered at the last visit.
Results
The mean skin incision length and operative time of nitinol staple-only fixation were 3.8 ± 0.5 cm and 19.6 ± 3.6 min, compared with 8.7 ± 1.3 cm and 48.8 ± 10.6 min for plate fixation, respectively. Bone union was confirmed in all patients without fibular shortening. Although no significant differences in patients with delayed wound healing, infection, or postoperative SAFE-Q scores were found between the two groups, more patients with plate fixation reported discomfort from the implant (71.4% vs. 32.3%) and requested its removal (75.0% vs. 35.5%).
Conclusion
Multiple nitinol staple-only fixations offer the advantages of a smaller skin incision, shorter operative time, lesser discomfort from the implants, and a reduced need for implant removal compared with antiglide plate fixation. Furthermore, staple-only fixation could achieve bone union without loss of correction. This suggests that multiple nitinol staple-only fixation may be less invasive and more beneficial for patients than antiglide plate fixation.
Publisher
BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
Subject
/ Aged
/ Alloys
/ Ankle
/ Female
/ Fracture Fixation, Internal - adverse effects
/ Fracture Fixation, Internal - instrumentation
/ Fracture Fixation, Internal - methods
/ Fractures, Bone - diagnostic imaging
/ Humans
/ Injuries
/ Internal fixation in fractures
/ Male
/ Medicine
/ Methods
/ Patients
/ Skin
/ Surgeons
/ Surgery
/ Surgical Stapling - adverse effects
