# Fixation of fibular head avulsion fractures with the proximal tibiofibular screw: Technique guide and clinical experience

## TL;DR

This paper describes a surgical technique using a cannulated screw to fix fibular head avulsion fractures, showing successful outcomes with bone healing and good joint motion.

## Contribution

The paper introduces a novel cannulated screw technique for fibular head avulsion fracture fixation with clinical results from a single surgeon's experience.

## Key findings

- All 37 patients achieved bony union with a mean follow-up of 3.5 years.
- Patients regained functional range of motion with mean extension of 1 degree and mean flexion of 121 degrees.
- Cannulated screw fixation allowed for robust stabilization and early joint motion.

## Abstract

Fibular head avulsion fractures are often associated with posterolateral corner injuries. Conventional fixation have consisted of transosseous or anchor-based suture techniques.

This technique paper reports on the use of a cannulated screw for fixation of fibular head avulsion fractures by a single surgeon at a tertiary referral center.

Thirty-seven patients underwent open reduction and internal fixation of fibular head avulsion fractures between 2006 and 2022.

At final follow up (mean 3.5 years ± 2.5) all fractures went on to bony union. All patients regained functional range of motion with mean extension of 1 degree (median 0 degrees, range 0 to −5 degrees) and mean flexion of 121 degrees (median 127.5 degrees, range 90 to 135 degrees).

Our results suggest that a cannulated screw across multiple cortices provides robust fixation and allows for early motion.