Evolving Technique Update: The Fibula Edward A. Perez, M.D. - - PowerPoint PPT Presentation

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Evolving Technique Update: The Fibula Edward A. Perez, M.D. - - PowerPoint PPT Presentation

Feb 27, 2023 272 likes •655 views

Evolving Technique Update: The Fibula Edward A. Perez, M.D. Campbell Clinic/University of Tennessee Memphis, TN Dr. Gus Sarmiento Orthopaedic Industrial Complex - A. Sarmiento Why? Evolution or Intelligent Design? -Toney Russell What is

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Evolving Technique Update: The Fibula

Edward A. Perez, M.D. Campbell Clinic/University of Tennessee Memphis, TN

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  • Dr. Gus Sarmiento
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Orthopaedic Industrial Complex

  • A. Sarmiento
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Why?

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What is next ….. ???

Evolution or Intelligent Design?

  • Toney Russell
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Problems

  • Comorbidities
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Problems

  • Compliance
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Problems

  • Osteoporosis
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Problems

  • Short segments
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Locking Plates

Are very powerful!

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Locking Plates

Enhance fixation

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Locking Plates

Come at a cost

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Locking Plates

Come at a cost

$$

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Locking Plates

Come at a cost

Biologic

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Locking Plates

Come at a cost

Biologic

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Low Profile Implants

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Low Profile Implants?

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Low Profile Implants?

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When Do I Use Locking Plates for Fibula Fractures?

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Bread and Butter

  • SER 4
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1/3 Tubular

Lag & Neutralization Plate

  • Low profile
  • Inexpensive
  • Proven
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1/3 Tubular

Lag & Neutralization Plate

  • Low profile
  • Inexpensive
  • Proven
  • 70%
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SER: Locking Plate

  • Very low fractures
  • Osteopenic bone
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SER: Locking Plate

  • Very low fractures
  • Osteopenic bone
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Pronation Abduction (PAB)

  • Comminution
  • Length unstable
  • Could have short segments
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PAB

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PAB

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Weber C (PER)

  • Short segment
  • Poor bone
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In Conclusion

  • Technology advances
  • Locked plates are powerful
  • Expensive
  • Soft tissue concern
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In Conclusion

  • Short segments
  • Poor bone quality
  • Use judiciously
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Thank You