[Osteosynthesis of distal fibular fractures with IlluminOss : Video article].

OBJECTIVE: The aim was minimally invasive osteosynthesis of a distal fibular fracture under the premises of poor soft tissue conditions and existing chronic comorbidities to enable rapid recovery and to reduce soft tissue stress in order to avoid postoperative infections and achieve early weight bearing. INDICATIONS: This involved a distal fibula fracture, classified as 44 B1.1, B1.2, B1.3 according to the working group for osteosynthesis (AO) or a B fracture after Danis and Weber with indications for surgery (cortical disruption and shaft offset > 5 mm), age > 65 years, poor soft tissue conditions and a Charlson score ≥ 1. CONTRAINDICATIONS: Acute or incompletely healed infection in the implantation area, allergy to dental adhesive or implant material, open fractures, multifragmentary and severely dislocated fractures. SURGICAL TECHNIQUE: The surgical technique is demonstrated in detail with the help of a video of the operation and which is available online. A 1-2 cm long incision at the distal pole of the fibula, insertion of an intramedullary wire, reaming of the medullary canal and insertion of the IlluminOss balloon implant, filling the balloon with monomer and curing using visible blue light (436 nm), shortening of the implant, radiological control and wound closure. FOLLOW-UP: Postoperative cooling and elevation of the affected limb, free mobility after postoperative day 1, pain-adjusted full load bearing in VacoPed boot for 6 weeks (depending on pain and swelling).
RESULTS: Study currently ongoing, no complications or revisions so far.