Biomechanical Analysis of Stability of Posterior Antiglide Plating in Osteoporotic Pronation Abduction Ankle Fracture Model With Posterior Tibial Fragment

Hartwich, Kathleen; Gómez, A. Golpe; Pyrc, Jarosław; Gut, Radosław; Rammelt, Stefan; Grass, R.

doi:10.1177/1071100716669359

Cited by 21 publications

(14 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Serveral studies have demonstrated that the posterolateral approach allows for a better quality of reduction of the PM fragment, particularly in the presence of smaller, depressed and intercalary fragments [5,19,[36][37][38][39][40]. Biomechanically, posterior screws and antiglide plates to the PM and distal fibula provide more stability than anterior-to posterior screws or lateral plates, respectively [33,36,37,41].…”

Section: Surgeon-related Risk Factorsmentioning

confidence: 99%

Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

Neumann

Kroker

Beyer

et al. 2022

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

Aims The treatment of ankle fractures and fracture-dislocations involving the posterior malleolus (PM) has undergone considerable changes over the past decade. The aim of our study was to identify risk factors related to the occurrence of complications in surgically treated ankle fractures with PM involvement. Patients and methods We retrospectively analyzed 300 patients at a mean age of 57 years with 300 ankle fractures involving the PM treated surgically at our institution over a 12-year period. The following relevant comorbidities were noted: arterial hypertension (43.7%; n = 131), diabetes mellitus (DM) (14.0%; n = 42), thereof insulin-dependent (3.7%; n = 11), peripheral vascular disease (0.7%; n = 2), osteoporosis (12.0%; n = 36), dementia (1.0%; n = 3), and rheumatoid arthritis (2.0%; n = 6). Furthermore, nicotine consumption was recorded in 7.3% (n = 22) and alcohol abuse in 4.0% (n = 12). Results Complications occurred in 41 patients (13.7%). A total of 20 (6.7%) revision surgeries had to be performed. Patients with DM (p < 0.001), peripheral vascular disease (p = 0.003) and arterial hypertension (p = 0.001) had a significantly increased risk of delayed wound healing. Alcohol abuse was associated with a significantly higher overall complication rate (OR 3.40; 95% CI 0.97–11.83; p = 0.043), increased rates of wound healing problems (OR 11.32; 95% CI 1.94–65.60; p = 0.001) and malalignment requiring revision (p = 0.033). The presence of an open fracture was associated with an increased rate of infection and wound necrosis requiring revision (OR 14.25; 95% CI 2.39–84.84; p < 0.001). Multivariate analysis identified BMI (p = 0.028), insulin-dependent DM (p = 0.003), and staged fixation (p = 0.043) as independent risk factors for delayed wound healing. Compared to the traditional lateral approach, using the posterolateral approach for fibular fixation did not lead to increased complication rates. Conclusions Significant risk factors for the occurrence of complications following PM fracture treatment were identified. An individually tailored treatment regimen that incorporates all risk factors is important for a good outcome.

show abstract

Section: Surgeon-related Risk Factorsmentioning

confidence: 99%

Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

Neumann

Kroker

Beyer

et al. 2022

Arch Orthop Trauma Surg

Self Cite

View full text Add to dashboard Cite

show abstract

“…In osteoporotic bone, a locking plate fixation might be advantageous. 126 Important structures that are at risk are the sural nerve, peroneal tendons and the flexor hallucis longus muscle. 121 , 127 In a cadaveric study, lesions to the tibialis anterior tendon were seen through posterior to anterior K-wires.…”

Section: Operative Treatmentmentioning

confidence: 99%

Current management of trimalleolar ankle fractures

et al. 2021

View full text Add to dashboard Cite

A trimalleolar ankle fracture is considered unstable and treatment is generally performed operatively. Computed tomography is important for the operative planning by providing an elaborated view of the posterior malleolus. Trimalleolar ankle fractures have a rising incidence in the last decade with up to 40 per 100,000 people per year. With a growing number of elderly patients, trimalleolar ankle injuries will become more relevant in the form of fragility fractures, posing a particular challenge for trauma surgeons. In patients with osteoporotic trimalleolar ankle fractures and relevant concomitant conditions, further evidence is awaited to specify indications for open reduction and internal fixation or primary transfixation of the ankle joint. In younger, more demanding patients, arthroscopic-assisted surgery might improve the outcome, but future research is required to identify patients who will benefit from assisted surgical care. This review considers current scientific findings regarding all three malleoli to understand the complexity of trimalleolar ankle injuries and provide the reader with an overview of treatment strategies and research, as well as future perspectives. Cite this article: EFORT Open Rev 2021;6:692-703. DOI: 10.1302/2058-5241.6.200138

show abstract

“…7,41 A buttress plate or lag screw can be used to fix the fracture. 42 This is biomechanically stronger, and a more logical approach than a screw sited from the anterior tibia, which commonly pushes the fragment away from, rather than lagging it to, the tibia. 43 The same incision can be used for Weber B/SER type fractures to fix the fibular fracture with an anti-glide plate.…”

Section: Cite This Articlementioning

confidence: 99%

Posterior malleolus fractures

Solan

Sakellariou

2017

The Bone & Joint Journal

View full text Add to dashboard Cite

The posterior malleolus component of a fracture of the ankle is important, yet often overlooked. Pre-operative CT scans to identify and classify the pattern of the fracture are not used enough. Posterior malleolus fractures are not difficult to fix. After reduction and fixation of the posterior malleolus, the articular surface of the tibia is restored; the fibula is out to length; the syndesmosis is more stable and the patient can rehabilitate faster. There is therefore considerable merit in fixing most posterior malleolus fractures. An early postoperative CT scan to ensure that accurate reduction has been achieved should also be considered. Cite this article:

show abstract

Biomechanical Analysis of Stability of Posterior Antiglide Plating in Osteoporotic Pronation Abduction Ankle Fracture Model With Posterior Tibial Fragment

Abstract: The clinical implication of this biomechanical study is that the posterior antiglide plating might be advantageous in patients with osteoporotic pronation abduction stage III ankle fracture.

Cited by 21 publications

References 44 publications

Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

Complications following surgical treatment of posterior malleolar fractures: an analysis of 300 cases

Current management of trimalleolar ankle fractures

Posterior malleolus fractures

Contact Info

Product

Resources

About