ArticleFoot & ankle international2026
Minimally Invasive Intramedullary Fixation vs Plate Fixation of Distal Fibular Fractures in Elderly Patients: A Natural Experiment.
Article in Foot & ankle international, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
backgroundThe aim of this study was to compare the postoperative complications and functional outcomes of intramedullary fixation (IMF) and conventional plate fixation (PF) for Lauge-Hansen supination external rotation type 4 fractures in patients aged 70 years or older.
methodsThis natural experiment involved 2 hospitals (A and B) in a single trauma region. Between June 2019 and January 2023, a total of 80 patients aged 70 years or older with an unstable supination external rotation type 4 fracture were treated with either a geriatric treatment pathway consisting of early-stage IMF following immediate protected full weight bearing in hospital A (n = 48) or PF using a one-third tubular locking plate in hospital B (n = 32). The primary outcome was the total number of postoperative complications during 12 months of follow-up.
resultsThe IMF group had a higher mean age compared with the PF group (79.8 vs 75.7 years,
conclusionIntramedullary fixation resulted in significantly less postoperative complications and better functional outcome compared to PF, despite the higher mean age of patients in the IMF group. A geriatric treatment pathway using an intramedullary nailing technique may be preferred over conventional PF in an elderly population, especially in case of patient obesity or compromised general health status.
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