Comminuted fibular head fractures with posterolateral knee instability: A novel repair technique using a tension-slide device

David J Cinats, Trevor Stone
Journal of Orthopaedic Trauma 2020 May 27
Comminuted proximal fibula fractures or arcuate fractures (OTA/AO 4F1B fractures), can defunction the posterolateral corner and result in posterolateral knee instability. Ongoing posterolateral knee instability can limit function, cause significant pain, and lead to early knee arthrosis. The anatomy of the posterolateral corner and proximal fibula limit the options for repair of this injury. The ideal method for osteosynthesis of these injuries has not been established. The goals of treatment include reconstitution of posterolateral stability, restoration of the anatomic relationship of posterolateral corner structures, and restoration of bone stock that would permit future reconstruction. This article characterizes the injury pattern, outlines the technique, and provides the clinical and radiographic outcomes of osteosynthesis of comminuted fibular head fractures using a novel application of the tension-slide technique.

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