PMC9986461_01
(A): 3D reconstruction of the injured lower leg showing diaphyseal distal tibia fracture and a proximal and distal fibula fracture. (B): X-rays antero-posterior and lateral view after surgical intervention by intramedullary nailing and plate osteosynthesis of the distal fibula fracture. (C): X-ray control 6 weeks after surgery. (D): Final X-ray approximately 7 months after surgery and shortly after plate removal at the distal fibula as well as removal of the set screw in the meantime. Note full osseous healing of the distal tibia and fibula fracture.
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A 63-year-old male patient (height 180cm, weight 95 kg) suffered from a closed fracture of the lower leg with a distal diaphyseal fracture of the tibia, a proximal and a distal fibular fracture (Figure 1A). The distal fibular fracture was treated by open reduction and plate osteosynthesis (VariAx 2 Distal fibula system, Stryker, Kalamazoo, USA) including restoration of a syndesmotic injury by using a set screw, whereas the proximal fibular fracture was not treated surgically (Figure 1B). Postoperatively, the patient was mobilized on forearm crutches with a partial weight-bearing recommendation of 20 kg for the first 6 weeks (Figure 1C).