CME OnDemand: 2022 AOFAS Annual Meeting-Anatomic Structures at Risk When Utilizing Percutaneous Intramedullary Fibular Screw Fixation for Lateral Malleolus Fractures: A Cadaveric Study

Anatomic Structures at Risk When Utilizing Percutaneous Intramedullary Fibular Screw Fixation for Lateral Malleolus Fractures: A Cadaveric Study

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This study aimed to assess the risk of injury to adjacent anatomical structures when utilizing percutaneous intramedullary fibular screw fixation for lateral malleolus fractures. Seven fresh-frozen below-the-knee cadaver specimens were used for the study. Prior to investigations, the specimens were inspected with fluoroscopic radiographs. Lateral dissection of the lateral malleolus was performed after screw placement to determine the proximity of the peroneus longus, peroneus brevis, and sural nerve to the inserted hardware. The distances between the structures and the hardware were calculated.<br /><br />The study found that percutaneous intramedullary fibular screw placement resulted in an injury to the sural nerve in only one of the seven specimens. The peroneus longus and peroneus brevis were not injured in any of the specimens.<br /><br />Lateral malleolus fractures are common fractures encountered by orthopedic surgeons, and retrograde intramedullary fixation has become a viable option for patients at higher risk for wound complications. This study provides valuable information about the proximity of adjacent anatomical structures to the hardware used in this fixation technique.<br /><br />In conclusion, this cadaveric study suggests that percutaneous intramedullary fibular screw fixation for lateral malleolus fractures has a low risk of injury to adjacent anatomical structures such as the peroneus longus, peroneus brevis, and sural nerve. However, it is important to consider individual patient factors and surgical technique when deciding on the appropriate fixation method for lateral malleolus fractures.

Asset Subtitle

Ashish Shah, MD, Zachary Littlefield, Brandon Boyd, David A. Patch, MD, Roshan Jacob, Srihari R. Prahad, Logan Reed, Joseph Elphingstone, Sean M. Young, Thomas Sanchez, Turner Sankey

Keywords

risk of injury

adjacent anatomical structures

percutaneous intramedullary fibular screw fixation

lateral malleolus fractures

fresh-frozen below-the-knee cadaver specimens

fluoroscopic radiographs

peroneus longus

peroneus brevis

sural nerve

proximity of structures