Dislocation is a risk factor for poor outcome after supination external rotation type ankle fractures

Sculco, Peter K.; Lazaro, Lionel E.; Little, Milton M. T.; Berkes, Marschall B.; Warner, Stephen J.; Helfet, David L.; Lorich, Dean G.

doi:10.1007/s00402-015-2353-0

Cited by 39 publications

(63 citation statements)

References 17 publications

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“…41,47 Increased soft-tissue injury has been shown to result in an increased rate of postoperative complications when not properly addressed. 8,22,47 One review of surgical complications in 121 ankle fractures found that ankle fracture-dislocations (n ¼ 41; 34%) had 3 times as many major complications, including infection, compared with standard fractures (19% vs 6.3%, P < .05). 22 In that same report, fractures-dislocations, which were not expeditiously treated, were found to have a higher major soft-tissue complication rate compared with standard ankle fractures (44% vs 5.3%).…”

Section: Soft-tissue Injurymentioning

confidence: 99%

“…40 Some recent studies, however, have shown no significant association between postoperative infections and wound complications when comparing standard ankle fractures to ankle fracture-dislocations. 47,56 In these reports, there was a significant number of ankle fracture-dislocations that were treated initially with the application of temporary external fixators and delayed operative intervention (19% vs 49%, P ¼ .003). 47 The use of external fixation and delayed surgery has been shown to be effective in other fractures with considerable soft-tissue injury such as pilon fractures.…”

Section: Soft-tissue Injurymentioning

confidence: 99%

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Ankle Fracture-Dislocations

Lawson

Ayala

Morin

et al. 2018

Foot & Ankle Orthopaedics

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Ankle fractures are common musculoskeletal injuries that may result in tibiotalar joint dislocations. Ankle fracturedislocations occur via similar mechanisms as ankle fractures, although the persistence or magnitude of the deforming force is sufficient to disrupt any remaining bony or soft-tissue stability. Ankle fracture-dislocations likely represent distinct clinical entities, as the pathology, management, and patient outcomes following these injuries differ from those seen in more common ankle fractures without dislocation. Ankle fracture-dislocations have higher rates of concomitant injury including open fractures, chondral lesions, and intra-articular loose bodies. Long-term outcomes in ankle fracture-dislocations are worse than ankle fractures without dislocation. Higher rates of posttraumatic osteoarthritis and chronic pain have also been reported. In this review, we discuss the current literature regarding the history, management, and outcomes of anklefracture dislocations and highlight the need for future study.

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Section: Soft-tissue Injurymentioning

confidence: 99%

Section: Soft-tissue Injurymentioning

confidence: 99%

Ankle Fracture-Dislocations

Lawson

Ayala

Morin

et al. 2018

Foot & Ankle Orthopaedics

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“…External fixators already play a fundamental role in the local damage control of ankle fracture dislocations not only to promote stabilization and comfort to the patient but also to improve soft tissue healing while waiting for definitive fixation [3,11,12,16,[24][25][26].…”

Section: Discussionmentioning

confidence: 99%

“…Local conditions are of crucial importance for the correct surgical planning, in both emergency treatment and definitive treatment [3].…”

Section: Introductionmentioning

confidence: 99%

“…After severe injuries, ankle wounds, both traumatic and surgical, may have problems healing. An injury of the ankle region can affect-in addition to bone, articular surface and ligament-any of the tendons, nerves or blood vessels that cross it [1,3,[9][10][11]. Poor local conditions can be encountered even in the early arrival to the emergency department or in the further days after trauma (Fig.…”

Section: Introductionmentioning

confidence: 99%

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A new approach to local DCO in ankle fracture dislocations: external fixation with diaphyseal unicortical screws applied by local anaesthesia

et al. 2017

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The procedure of monocortical diaphyseal application in bridging external fixation is comparable to the conventional transcalcaneal traction maintaining the advantage in terms of speediness, independence from anaesthetists and feasibility within few minutes from hospital admittance even in patients under anticoagulants therapy, but increasing the stability of the reduction and improving the quality of nursing (so-called portable traction).

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Arthroskopisch assistierte Frakturversorgung am oberen Sprunggelenk

et al. 2016

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Acute ankle fractures are one of the most common fractures in adults with an incidence of 0.1-0.2 % per year. Operative treatment by open reduction and internal fixation (ORIF) is the standard method of treatment for unstable or dislocated fractures. The main goal of the operation is the anatomical realignment of the joint and restoration of ankle stability; nevertheless, anatomical reduction does not automatically lead to favorable clinical results. According to several studies the mid-term and in particular the long-term outcome following operative treatment is often poor with residual symptoms including chronic pain, stiffness, recurrent swelling and ankle instability. There is growing evidence that this poor outcome might be related to occult intra-articular injuries involving cartilage and soft tissues. In recent studies the frequency of fracture-related osteochondral lesions was reported to be approximately 64 %. By physical examination, standard radiography or even computed tomography (CT), these intra-articular pathologies cannot be reliably diagnosed; therefore, many authors emphasize the value of ankle arthroscopy in acute fracture treatment as it has become a safe and effective diagnostic and therapeutic procedure. Arthroscopically assisted open reduction and internal fixation (AORIF) allows control of the reduction as well examination of all intra-articular structures. If necessary, intra-articular pathologies can be addressed by removing ruptured ligaments and loose bodies, performing chondroplasty or microfracturing. So far there is no evidence that supplementary ankle arthroscopy increases the complication rate. On the other hand, the positive effect of AORIF has also not been clearly documented; nevertheless, there are clear indications that arthroscopically assisted fracture treatment is beneficial, especially in complex fractures.

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Dislocation is a risk factor for poor outcome after supination external rotation type ankle fractures

Cited by 39 publications

References 17 publications

Ankle Fracture-Dislocations

Ankle Fracture-Dislocations

A new approach to local DCO in ankle fracture dislocations: external fixation with diaphyseal unicortical screws applied by local anaesthesia

Arthroskopisch assistierte Frakturversorgung am oberen Sprunggelenk

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