Ankle Fractures: Fixing the Fracture With a Bone Nail and Screws Animation

Ankle Fractures: Fixing the Fracture With a Bone Nail and Screws Animation

When a patient suffers a broken ankle or fracture on the outside bone of their lower leg, called the fibula, there are a few options for the surgeon to stabilize and fix the broken bone. This animation will show a minimally invasive bone nail that is inserted into the bone to hold the fracture while it heals.

The surgeon will mark out the skin for an incision over the outside portion of the ankle near the broken bone. A combination of clamps could be used to realign the broken pieces of bone and prepare them for stabilization. A small pin or wire is placed from the bottom of the bone through the lower portion of the broken bone into the upper portion to hold the two in place and ultimately help guide the nail that will be used.

The surgeon will use a combination of x-ray angles to verify that the wire is, in fact, in the center of the bone. Once the position of the wire is verified, the surgeon will insert it completely into the fibula bone. A large reamer drill is used to open up the canal in the bone and prepare that area for the nail. Special depth guides are used to be sure the reamers make it to the intended portion of the bone.

Once the larger hole is opened, a smaller reamer is used to make room in the canal further up the fibula. There are different lengths and sizes of nails depending on the size of the patient's bone. Guides are used to position the nail correctly and the nail is inserted while it is attached to a drill guide. This guide will help place final locking screws to secure the nail in place after insertion into the bone canal.

Small wires are used along with x-ray images to be sure the guide aligns well with the holes in the nail so as the surgeon drills for the final screws, there is no contact with the nail itself. A screwdriver is placed into the nail and turned. This activates small tabs or talons at the end of the nail. They then flare out into the surrounding bone and help secure the nail in place.

Drill sleeves and guides are then placed into the holes of the outrigger guide, and screws are placed into the bone and through the nail for final fixation into place.