Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures

Abstract Background Interest in less invasive surgeries for Weber type B distal fibular fracture has increased recently. This study aimed to demonstrate that nitinol staple-only fixation is less invasive compared to antiglide plate fixation. Materials and methods This retrospective review involved 5...

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Main Authors: Kensei Yoshimoto, Masahiko Noguchi, Takumi Koseki, Ayako Tominaga, Ken Okazaki
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-025-08835-1
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author Kensei Yoshimoto
Masahiko Noguchi
Takumi Koseki
Ayako Tominaga
Ken Okazaki
author_facet Kensei Yoshimoto
Masahiko Noguchi
Takumi Koseki
Ayako Tominaga
Ken Okazaki
author_sort Kensei Yoshimoto
collection DOAJ
description Abstract Background Interest in less invasive surgeries for Weber type B distal fibular fracture has increased recently. This study aimed to demonstrate that nitinol staple-only fixation is less invasive compared to antiglide plate fixation. Materials and methods This retrospective review involved 59 patients with Weber type B fibular fractures who underwent surgery between 2018 and 2023. Twenty-eight patients underwent antiglide plate fixation, whereas 31 underwent multiple nitinol staple-only fixation. The intraoperative assessment included skin incision length and operative time. The radiographic outcomes were bone union and fibular length. The clinical outcomes included delayed wound healing, infection, discomfort from the implant, implant removal, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) score administered at the last visit. Results The mean skin incision length and operative time of nitinol staple-only fixation were 3.8 ± 0.5 cm and 19.6 ± 3.6 min, compared with 8.7 ± 1.3 cm and 48.8 ± 10.6 min for plate fixation, respectively. Bone union was confirmed in all patients without fibular shortening. Although no significant differences in patients with delayed wound healing, infection, or postoperative SAFE-Q scores were found between the two groups, more patients with plate fixation reported discomfort from the implant (71.4% vs. 32.3%) and requested its removal (75.0% vs. 35.5%). Conclusion Multiple nitinol staple-only fixations offer the advantages of a smaller skin incision, shorter operative time, lesser discomfort from the implants, and a reduced need for implant removal compared with antiglide plate fixation. Furthermore, staple-only fixation could achieve bone union without loss of correction. This suggests that multiple nitinol staple-only fixation may be less invasive and more beneficial for patients than antiglide plate fixation.
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spelling doaj-art-d1e51214a20841269da449ff327120a62025-08-20T02:05:43ZengBMCBMC Musculoskeletal Disorders1471-24742025-06-012611810.1186/s12891-025-08835-1Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fracturesKensei Yoshimoto0Masahiko Noguchi1Takumi Koseki2Ayako Tominaga3Ken Okazaki4Orthopaedic Foot and Ankle Center, Shiseikai Daini HospitalOrthopaedic Foot and Ankle Center, Shiseikai Daini HospitalOrthopaedic Foot and Ankle Center, Shiseikai Daini HospitalOrthopaedic Foot and Ankle Center, Shiseikai Daini HospitalDepartment of Orthopedic Surgery, Tokyo Women’s Medical UniversityAbstract Background Interest in less invasive surgeries for Weber type B distal fibular fracture has increased recently. This study aimed to demonstrate that nitinol staple-only fixation is less invasive compared to antiglide plate fixation. Materials and methods This retrospective review involved 59 patients with Weber type B fibular fractures who underwent surgery between 2018 and 2023. Twenty-eight patients underwent antiglide plate fixation, whereas 31 underwent multiple nitinol staple-only fixation. The intraoperative assessment included skin incision length and operative time. The radiographic outcomes were bone union and fibular length. The clinical outcomes included delayed wound healing, infection, discomfort from the implant, implant removal, and the Self-Administered Foot Evaluation Questionnaire (SAFE-Q) score administered at the last visit. Results The mean skin incision length and operative time of nitinol staple-only fixation were 3.8 ± 0.5 cm and 19.6 ± 3.6 min, compared with 8.7 ± 1.3 cm and 48.8 ± 10.6 min for plate fixation, respectively. Bone union was confirmed in all patients without fibular shortening. Although no significant differences in patients with delayed wound healing, infection, or postoperative SAFE-Q scores were found between the two groups, more patients with plate fixation reported discomfort from the implant (71.4% vs. 32.3%) and requested its removal (75.0% vs. 35.5%). Conclusion Multiple nitinol staple-only fixations offer the advantages of a smaller skin incision, shorter operative time, lesser discomfort from the implants, and a reduced need for implant removal compared with antiglide plate fixation. Furthermore, staple-only fixation could achieve bone union without loss of correction. This suggests that multiple nitinol staple-only fixation may be less invasive and more beneficial for patients than antiglide plate fixation.https://doi.org/10.1186/s12891-025-08835-1Fibula fractureAnkle fractureFracture fixationNitinol staplesAntiglide plates
spellingShingle Kensei Yoshimoto
Masahiko Noguchi
Takumi Koseki
Ayako Tominaga
Ken Okazaki
Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
BMC Musculoskeletal Disorders
Fibula fracture
Ankle fracture
Fracture fixation
Nitinol staples
Antiglide plates
title Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
title_full Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
title_fullStr Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
title_full_unstemmed Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
title_short Comparative effectiveness of nitinol staple-only fixation versus antiglide plate fixation for Weber type B distal fibular fractures
title_sort comparative effectiveness of nitinol staple only fixation versus antiglide plate fixation for weber type b distal fibular fractures
topic Fibula fracture
Ankle fracture
Fracture fixation
Nitinol staples
Antiglide plates
url https://doi.org/10.1186/s12891-025-08835-1
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