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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2025-06-01
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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 |
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| 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. |
| format | Article |
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| language | English |
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| publisher | BMC |
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| series | BMC Musculoskeletal Disorders |
| 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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