AB220. 85. Effect of Immediate weight bearing following ankle fracture fixation

O’Dwyer, Conor; McDonald, Ciaran; McLoughlin, Peter; Dumbrava, Daniel; Bayer, Thomas

doi:10.21037/map.2019.ab220

Cited by 1 publication

(6 citation statements)

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“…Conversely, a strong positive correlation was observed between smoking and postsurgical complications ( P = 0.004). This demonstrates that preinjury circumstances may determine the success and speed of recovery, providing insight into potential operative outcomes 4,15,16 . Smoking was indicated as a significant predictor of postoperative complications in this cohort.…”

Section: Possible Concerns and Future Of The Techniquementioning

confidence: 65%

“…This demonstrates that preinjury circumstances may determine the success and speed of recovery, providing insight into potential operative outcomes. 4,15,16 Smoking was indicated as a significant predictor of postoperative complications in this cohort. All other preoperative factors did not achieve statistical significance, which may be due to the sample size, duration of follow-up assessment, and notable variance in fracture classification.…”

Section: Possible Concerns and Future Of The Techniquementioning

confidence: 68%

“…Retrospective studies have demonstrated that the risk of posttraumatic arthrosis is as high as 34% in patients presenting with trimalleolar ankle fractures. This illustrates the difficulty in providing satisfactory outcomes to this patient cohort and highlights that high-quality anatomic reduction is necessary to optimize biomechanical outcomes and reduce the risk of long-term degenerative complications that may ensue 3,4 . Injuries involving the ankle joint commonly result from rotational forces or high-energy trauma and are associated with increased comminution and soft tissue compromise 3,5 .…”

Section: Historical Perspectivementioning

confidence: 95%

“…Both groups were mobilized weight-bearing as tolerated after fixation. Inadequate anatomic reduction can precipitate complications, such as reduced functionality and posttraumatic arthritis, suggesting that fixation of PM fragments is necessary for successful immediate weight-bearing and thus reducing joint rigidity 4,15 . Further, Cunningham and colleagues investigated the influence of immediate weight-bearing protocols on the recovery process after surgical fixation of trimalleolar fractures.…”

Section: Possible Concerns and Future Of The Techniquementioning

confidence: 99%

“…This illustrates the difficulty in providing satisfactory outcomes to this patient cohort and highlights that high-quality anatomic reduction is necessary to optimize biomechanical outcomes and reduce the risk of longterm degenerative complications that may ensue. 3,4 Injuries involving the ankle joint commonly result from rotational forces or high-energy trauma and are associated with increased comminution and soft tissue compromise. 3,5 The mechanism of injury is often secondary to the external rotation of the talus under the tibial plafond, with the foot in supination.…”

Section: Historical Perspectivementioning

confidence: 99%

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Comparison of Two Surgical Approaches for Trimalleolar Ankle Fracture Fixation

O’ Reilly,

Ní Fhóghlú,

Mahon

et al. 2023

Techniques in Foot &Amp; Ankle Surgery

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Ankle fractures account for 10% of all presenting fractures, with research quoting the involvement of the posterior malleolus in around 7% of cases. Trimalleolar fractures are estimated to have greater long-term complications due to the significant disruption to the articular surface of the joint and the reduced weight-bearing potential associated with this. Despite the well-documented role of the posterior malleolus in ankle fractures, its fixation is often a matter of debate. One barrier to this is the potential need for an additional surgical incision. Our study compared two surgical approaches to trimalleolar ankle fracture fixation: One through an extended posterolateral and medial approach (2-incision approach) and one through a combined posterolateral, direct lateral, and medial approach (3-incision approach). Thirty-eight open reduction and internal fixation of trimalleolar ankle fractures were performed by the senior author in a single institution between January 2017 and January 2020. Fifteen underwent a 2-incision approach and 3 separate incisions were used in 23 cases. Outcomes of the two different surgical methods included a postoperative functional score (Ankle-Hindfoot American Orthopedic Foot and Ankle Society), postoperative complications, and evaluation of postoperative radiographs. Twenty-three patients were recruited to the 3-incision group and 15 to the 2-incision group. The utilization of 3 separate incisions for the fixation of trimalleolar fractures showed fewer complications than a 2-incision approach. Further, smoking was positively correlated with reported complications. All other perioperative variables did not reach statistical significance. In our study, a 3-incision approach showed a tendency for lower complication rates in the surgical treatment of trimalleolar ankle fractures compared with a 2-incision approach. In our opinion, a direct approach to the 3 malleoli through individual incisions allows better visualization of the fracture site, including intercalary and incisura fragments, enabling better reduction and avoiding unnecessary destructive tissue handling. Level of Evidence: Diagnostic Level 2. See Instructions for Authors for a complete description of levels of evidence.

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Section: Possible Concerns and Future Of The Techniquementioning

confidence: 65%

Section: Possible Concerns and Future Of The Techniquementioning

confidence: 68%