The best surgeons’ treatment for an athlete’s broken ankle
The Sonoma FibuLock™ pin is a cutting edge, minimally-invasive treatment for ankle fractures. This implant can get patients back to activity faster with less pain and skin issues than traditional surgical plates because the FibuLock™ Pin rests within the bone instead of on the bone surface.
The FibuLock™ pin is inserted into the bone through a tiny incision. Once inside the bone, the pin acts like an internal splint to stabilize the fracture during healing. This is quite different from plates that are attached to the top of the bone with screws and can often be felt through the skin.
About 20% of plate patients have a second surgery to have their plates removed due to discomfort under the skin (Study by Johan H. Pot, 2011) . After removal, the patients require additional weeks of rehabilitation. The FibuLock™ pin generally does not need to be removed after healing, which eliminates the need for additional surgery and the resulting rehabilitation.
Ankle plates have been used for decades to repair fractured ankles. Plates usually heal the fractured bone, but are fairly invasive. Typically, a 4-inch to 6-inch incision is required, and the blood-supplying surface of the bone is stripped away to prepare for the plate. This surgical trauma slows down healing-time. In addition, plates rest just under the skin and patients commonly complain about pain from when the plate contacts their footwear or accidentally gets hit during sports or daily activities.
A more serious complication of fixing an ankle fracture with a plate is the risk of infection due to the large incision. This infection risk increases for patients with difficulty healing due to issues such as diabetes, being overweight or smoking.
FibuLock™ Saves the Skin
Scars from large incisions are not attractive and are generally not harmful, but a wound infection can be.
Wounds from large incisions are more difficult to keep clean in foot and ankle surgeries than other parts of the body. Unfortunately, a wound infection can lead to some very serious complications including amputation in rare circumstances. The small incisions used for the FibuLock™ pin should reduce the probability of an incision infection.
A recent study investigated whether an ankle pin would reduce the incidence of wound and implant issues while delivering the same healing and fracture alignment rates as surgical plates. The study compared 50 plate and 50 pin patients. Ankle function was slightly better for the pin group. Additionally, 16% of plate patients had wound infections, while there were zero infections in pin patients.
K.E. Bugler, T.O. White, P.T. Appleton, M.M. McQueen and C.M. Court-Brown. A Prospective, Randomised Controlled Trial Of A Fibular Nail Versus Standard Open Reduction And Internal Fixation For Fixation Of Ankle Fractures In Elderly Patients. Bone Joint J 2013 vol. 95-B no. SUPP 25 8
Step 1: A tiny incision is made below the ankle (sometimes a larger incision is required) Step 2: The inside of the bone is prepared for the pin Step 3: The pin is inserted Step 4: Stitches are used to close the tiny incisions
Step 1: A 4-inch to 6-inch incision is made over the fracture Step 2: The fractured bone is realigned and held in place with a screw Step 3: The soft tissue is scraped away from the bone and plate is fastened to the bone with additional screws Step 4: The wound is closed with stitches
I use the FibuLock™ pin because it is far less invasive than standard surgical plates. The FibuLock™ pin preserves the skin, tissues and blood supply to the ankle and allows faster return to sport for athletes.
Terry M. Philbin, DO Columbus, OH
Treating ankle fractures with an intramedullary nail allows the surgeon to achieve excellent, reproducible, and rigid fixation in a minimally invasive fashion that decreases incision size and the risk of infection.
Brian Carpenter, DPM Dallas/Ft. Worth, TX
While intramedullary pinning has been established as the treatment of choice for diaphyseal fractures of the femur and tibia, its role in the management of fibular fractures hasn’t been possible until now. The FibuLock™ is a well-designed implant that reduces the risk of wound infection, wound breakdown and hardware prominence that have reported complication rates up to 30% in plates. With the minimal incision technique and the low profile, the risks of developing wound complications is greatly diminished.
Selene Parekh Durham, NC
FibuLock™ allows for minimally invasive surgery both with regards to the skin and blood supply. This allows for faster bone healing and fewer wound complications, resulting in a quicker return to play. By using this technique, athletes can begin training and rehabilitation much sooner than traditional techniques.
Matthew Bradley, MD St. Louis, MO
The FibuLock™ Pin Is Used for Most Ankle Fracture Types
Q: How long does it take to return to normal activities?
A: This all depends on the fracture type, patient and surgeon. It is imperative that the patient follow their surgeon's instructions. However, some patients have walked 2 days after surgery.
Q: Will I have to get the FibuLock™ removed?
A: It is unlikely that you will have your FibuLock™ removed. Some people prefer to have it removed because they do not like the idea of having a metal pin in their ankle. In these cases, the FibuLock™ may be removed very simply through very small incisions.
Q: Is the FibuLock™ only for athletes?
A: Absolutely not. Most patients implanted with the FibuLock™ are not athletes.
Q: How long will it take for the incisions to heal?
A: Once again, this all depends on the patient’s healing ability. Generally, the small incisions of FibuLock™ will heal faster than the large incisions of a plate and screws.
Q: Is the FibuLock™ covered by insurance?
A: If your insurance plan covers surgical repair of ankle fractures, then the FibuLock™ is most likely covered. This will have to be confirmed with your insurance company and can be assisted by your surgeon’s office.
Q: Can the FibuLock™ Pin be used for my fracture?
A: The FibuLock™ Pin can be used for most ankle fracture types including nonunions
Why do the best ankle fracture surgeons choose the FibuLock™ pin?
If you have a broken ankle, or care about someone who does, the smartest thing you can do is look for the best surgeon in your area for treatment. (It is also not uncommon to seek a second opinion.) Every fracture and patient is different. A surgeon’s training helps them make an educated decision on the best course of treatment for each case.
For many patients, the FibuLock™ pin is an excellent treatment option that is growing in popularity among some of the world’s best ankle fracture surgeons. Of course, it is up to the patient and surgeon to determine if the FibuLock™ pin is the correct treatment choice.