Altering standard AO/ASIF techniques when performing open reduction with internal fixation of fibular fractures by using cancellous screws in place of cortical screws appears to be a viable option. By eliminating a few steps in screw application, the additive effect can lead to a significant decrease in operative and tourniquet time. Close inspection of hardware postoperatively has failed to show any signs of screw loosening or delay in fracture healing. In those cases when hardware has had to be removed, it was noted that screw tightness had not been altered. This topic has been anecdotally discussed within our institution and will be the subject of future scientific investigation. The authors feel that the application of fibular plates with cancellous screws is an acceptable alternative to standard orthopedic technique. Although we do not routinely vary from standard AO/ASIF technique, we feel this particular alteration does not affect outcome other than reducing surgical and tourniquet time, therefore reducing the surgical risks.
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