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老年Weber C型踝关节粉碎性骨折患者的髓内腓骨钉固定:病例报告

Intramedullary Fibular Nail Fixation in an Elderly Patient with a Comminuted Weber C Ankle Fracture: A Case Report.

作者信息

Kannan Ajith Kumar, Tyagi Anisha, Dong Johnny, Logothetis Elias, Bhuta Jay, Mittal Rahul

机构信息

Department of Health Informatics, Rutgers, NJ, USA.

Robert Wood Johnson Medical School, Rutgers, NJ, USA.

出版信息

J Orthop Case Rep. 2025 Jun;15(6):68-73. doi: 10.13107/jocr.2025.v15.i06.5668.

Abstract

INTRODUCTION

Ankle fractures are among the most common lower extremity injuries, accounting for approximately 9% of all fractures. Various methods exist for the internal fixation of fibular fractures, with open reduction and internal fixation using plates and screws currently regarded as the gold standard. However, plate and screw fixation is highly invasive and may lead to significant post-operative complications. Intramedullary (IM) nails, offering a less invasive alternative, have conventionally been indicated for non-comminuted Weber B and C fractures. To our knowledge, this is one of the few reports in the literature demonstrating the successful application of IM nails in a comminuted Weber C fracture.

CASE REPORT

We describe an 80-year-old female of Caucasian descent who presented with a comminuted Weber C ankle fracture following a fall. The patient was treated with fibular nail fixation, a minimally invasive technique that achieved successful alignment and stabilization. The patient had an uneventful recovery with no post-operative complications, highlighting the potential of this method in managing complex fractures in elderly patients with comorbidities.

CONCLUSION

This case underscores the versatility and efficacy of IM nails in treating complex fibular fractures, including comminuted Weber C fractures. It highlights the clinical relevance of this technique as a less invasive and complication-reducing alternative to traditional plating systems, particularly for elderly patients with high surgical risks. The findings suggest that IM fixation has the potential to significantly advance fracture management strategies and reduce associated morbidity.

摘要

引言

踝关节骨折是最常见的下肢损伤之一,约占所有骨折的9%。腓骨骨折的内固定方法有多种,目前切开复位钢板螺钉内固定被视为金标准。然而,钢板螺钉固定具有高度侵入性,可能导致严重的术后并发症。髓内钉提供了一种侵入性较小的替代方法,传统上适用于非粉碎性Weber B型和C型骨折。据我们所知,这是文献中少数几例证明髓内钉成功应用于粉碎性Weber C型骨折的报道之一。

病例报告

我们描述了一名80岁的白种女性,她因跌倒后出现粉碎性Weber C型踝关节骨折。患者接受了腓骨髓内钉固定治疗,这是一种微创技术,成功实现了对线和稳定。患者恢复顺利,无术后并发症,突出了该方法在治疗合并症老年患者复杂骨折中的潜力。

结论

该病例强调了髓内钉在治疗复杂腓骨骨折(包括粉碎性Weber C型骨折)中的多功能性和有效性。它突出了该技术作为传统钢板系统侵入性较小且并发症较少的替代方法的临床相关性,特别是对于手术风险高的老年患者。研究结果表明,髓内固定有可能显著推进骨折治疗策略并降低相关发病率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/85e6/12159630/628ad8d4b3cc/JOCR-15-68-g001.jpg

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