Open Reduction Internal Fixation of the Distal Fibula

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Evolution of Open Reduction Internal Fixation of the Distal Fibula

The procedure that is most commonly performed for unstable fractures of the lateral malleolus, also known as the distal fibula, is open reduction and internal fixation of the distal fibula. The surgery is performed through either a direct lateral incision which is on the outside of the ankle directly overlying the bone, or through a posterior lateral incision which is slightly behind the fibula bone on the outside of the ankle. The fracture site, or broken portion of the bone, is then identified and any damaged portion of it or the surrounding tissue that cannot be repaired is removed. The ends of the bone are then aligned and held in place with either clamps or removable wires and intra-operative X-ray or fluoroscopy is utilized to make sure that the bone is appropriately aligned. The fracture reduction and alignment is then permanently held in place using plates and screws which are left in place permanently unless they cause symptoms. Following surgery patients will often be left in a splint to the foot and ankle for 2-4 weeks to allow for the bone to heal and the soft tissue to rest. Patients will most commonly follow-up with their surgeon at 2 weeks following surgery to have their sutures of staples removed and then again at 6 weeks for X-rays to assess for fracture healing. The patient will not be allowed to walk on the ankle until post-operative X-rays demonstrate full bone healing which commonly occurs at 6-8 weeks following surgery.

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