Screw-only fibular construct for Weber B ankle fractures: A retrospective clinical and cost comparison to assess feasibility for resource-limited settings

•The majority of the global population live in resource-limited countries, where implant cost may limit surgical treatment of ankle fractures.As the fibula carries only 6.4-17% of bodyweight in stance, the biomechanical strength required of fibular fixation constructs is in question.•We demonstrate a novel screw-only technique (SOT) with two fibula pro tibia screws to neutralize an interfragmentary screw.•The screw-only fixation had a lower implant cost (mean $592 for screw only fixation versus mean $1,949.97 for the standard treatment).•All patients maintained an anatomic mortise throughout the postoperative period, but there was a higher rate of hardware removal in the SOT group.