Locked Intramedullary XS Nail for Ankle Fractures - Design, Biomechanics and Preliminary Results

The objective of this study is to emphasize the design and characteristics of XS Nail, as well as to analyze the primary results regarding the treatment of 5 patients with distal fibula fractures using this innovative implant. The XS nail is a straight cannulated small intramedullary implant with multiple holes, spaced 9mm apart that allow for placement with cross-locking threaded wires using an aiming device. 5 patients with isolated lateral fibular fractures, were treated with precise open fracture repositioning and osteosynthesis using XS nail. All fibular fractures healed without problems, with no soft tissue complications. According to Olerud score, all 5 patients had an excellent outcome. The XS nail can additionally be used in percutaneous technique for concomitant fractures of the fibula in distal metaphyseal fractures of the lower leg and pilon fractures. Even if our study group is small, our excellent results combined with the huge clinical experience of the implant designers, demonstrated that osteosynthesis with XS nail represents a good alternative to classic plate osteosynthesis for distal fibula, pilon or lower leg fractures, avoiding soft tissue complications, and ensuring a secure fracture fixation with a higher weight bearing capacity.