Presentation
For follow up: status post right ankle open reduction internal fixation (ORIF) and syndesmotic repair.
Patient Data
1. A tubular plate and 7 screws are transfixed through the distal fibular shaft fracture. At the inferior aspect of the plate there is hardware consisting of an additional tibial screw in continuity with a radio-opaque component that enters the tibiofibular clear space and is in alignment with a threaded tibial screw, consistent with the Fibulink syndesmotic system. All components are without evidence of hardware failure or loosening.
2. Mild soft tissue swelling and postoperative edema around the distal lower leg and the ankle. The bone density appears normal.
3. Anatomic alignment at the fibular fracture site with some evidence of healing.
4. Slight effacement of the lateral clear space at the ankle mortise.
5. Mild cortical irregularity in the region of the posterior malleolus may be due to a healing fracture.
Case Discussion
The FIBULINK® Syndesmosis Repair System is a newer device (c.2021) used for syndesmotic fixation in cases of syndesmosis disruption, either in isolation or as a result of an ankle fracture. It can be used in lieu of syndesmotic screws and is different from contemporary suture button constructs. Notably, it does not require the medial incision or hardware.
FIBULINK® is an aperture fixation device composed of a threaded tibia anchor (radio-opaque), fixed length suture bridge (radio-lucent), and telescoping fibular anchor (radio-opaque) which is attached to a fibular tensioning cap (radio-opaque). Insertion is performed via a lateral incision through an interfacing fixation plate, as in this patient, or via a washer if this plate is not present.
This case was submitted with supervision and input from:
Soni C. Chawla, M.D.
Associate Professor
Department of Radiological Sciences
David Geffen School of Medicine at UCLA
Olive View - UCLA Medical Center
Disclosure: I, Hilary Bowman, have no actual or potential ethical or financial conflict of interest in relation to this device. This case is not intended to be a personal endorsement or recommendation of this product.
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