Early and mid-term results of transarticular external fixation in the treatment of supination-external rotation type IV equivalent ankle fractures

Li, Bo-Hua; Wang, Shanxi; Li, Jun; Huang, Fuguo; Xiang, Zhou; Fang, Yue; Zhong, Gang; Yi, Min; Zhao, Xiaodan; Лю, Лэй

doi:10.1016/j.cjtee.2018.03.004

Cited by 5 publications

(5 citation statements)

References 28 publications

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“…Despite the difference in hospitalisation duration between HVCs and LVCs, the mean LOS ranks at the lower end of the described LOS in the literature [23,[27][28][29][30][31]. Regarding the differences in the LOS, a multicenter analysis from the Netherlands demonstrated longer hospitalisation at HVCs for fractures of the lower extremities.…”

Section: Discussionmentioning

confidence: 92%

Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study

Vehling

Canal

Ziegenhain

et al. 2021

Eur J Trauma Emerg Surg

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Introduction In light of current discussions about centralisation and teaching in medicine, we wanted to investigate the differences in in-hospital outcomes after surgical treatment of isolated ankle fractures, taking into account high-volume centres (HVCs) and low-volume centres (LVCs) and teaching procedures. Methods A retrospective analysis of malleolar fractures recorded in a National Quality Assurance Database (AQC) from the period 01-01-1998 to 31-12-2018 was carried out. Inclusion criteria were isolated, and operatively treated lateral malleolar fractures (ICD-10 Code S82.6 and corresponding procedure codes). Variables were sought in bivariate and multivariate analyses. A total of 6760 cases were included. By dividing the total cases arbitrarily in half, 12 HVCs (n = 3327, 49%) and 56 LVCs (n = 3433, 51%) were identified. Results Patients in HVCs were younger (48 vs. 50 years old), had more comorbidities (26% vs. 19%) and had more open fractures (0.48% vs. 0.15%). Open reduction and internal fixation was the most common operative treatment at HVCs and LVCs (95% vs. 98%). A more frequent use of external fixation (2.5% vs. 0.55%) was reported at HVCs. There was no difference in mortality between treatment at HVCs and LVCs. A longer hospitalisation of 7.2 ± 5 days at HVCs vs. 6.3 ± 4.8 days at LVCs was observed. In addition, a higher rate of complications of 3.2% was found at HVCs compared to 1.9% at LVCs. The frequency of teaching operations was significantly higher at HVCs (30% vs. 26%). Teaching status had no influence on mortality or complications but was associated with a prolonged length of stay and operating time. Conclusion We found significant differences between HVCs and LVCs in terms of in-hospital outcomes for ankle fractures. These differences could be explained due to a more severely ill patient population and more complex (also open) fracture patterns with resulting use of external fixation and longer duration of surgery. However, structural and organisational differences, such as an extended preoperative stays at HVCs and a higher teaching rate, were also apparent. No difference in mortality could be detected.

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Section: Discussionmentioning

confidence: 92%

Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study

Vehling

Canal

Ziegenhain

et al. 2021

Eur J Trauma Emerg Surg

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“…As mentioned before, our previous study had shown that ORIF with TEF could achieve satisfactory outcomes in treating SER IV ankle fractures [15]. The present study retrospectively analyzed the results of 43 patients with SER IV ankle fractures who received ORIF with TEF (group 1) or ORIF with DLR (group 2).…”

Section: Discussionmentioning

confidence: 90%

“…Previous studies had shown that transarticular external fixators might raplace the plaster casts well by offering the opportunity for self-healing of deltoid ligament and allowing early weight bearing [12–14]. Our previous study had also shown that open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no DLR could achieve satisfactory outcomes in treating SER IV ankle fractures [15].…”

Section: Introductionmentioning

confidence: 99%

Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study

Wang

Zhang

et al. 2019

BMC Musculoskelet Disord

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Background The topic that whether the injured deltoid ligament should be repaired when associated with ankle joint fractures is still discussed. The objective of this study was to compare the clinical effect of open reduction and internal fixation (ORIF) with deltoid ligament repair (DLR) or transarticular external fixation (TEF) in treating supination-external rotation type IV (SER IV) ankle fractures. Methods Between January 2012 and December 2015, 43 patients were diagnosed as SER IV ankle fractures, 20 underwent ORIF and transarticular external fixation (TEF) without DLR (group 1), 23 were treated with ORIF and DLR (group 2). The pre- and post-operative radiographic examination were performed, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the visual analog scale (VAS), the Medical Outcomes Short Form 36-item questionnaire score (SF-36), and the ankle range of motion (ROM) were used for functional evaluation. Results In both groups, the three scores improved significantly after surgery, but there was no significant difference between the two groups. At 6 weeks after surgery, patients in group 2 had better ankle ROM than group 1 (29.35 ± 2.033 vs. 40.35 ± 3.550, P < 0.001), but there was no difference at 12 months postoperatively. No cases of bone nonunion or post-traumatic arthritic changes were seen during the follow-up. Patients in group 1 required a shorter time to achieve fracture union than patients in group 2. Conclusions ORIF with TIF is an optional strategy to manage SER IV ankle fractures as it achieves comparable functional results to ORIF with DLR. It also allows patients to start relatively earlier weight-bearing and may promote fracture union.

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“…Previous studies had shown that transarticular external fixators might raplace the plaster casts well by offering the opportunity for self-healing of deltoid ligament and allowing early weight bearing [12][13][14]. Our previous study had also shown that open reduction and internal fixation (ORIF) with transarticular external fixation (TEF) but no DLR could achieve satisfactory outcomes in treating SER IV ankle fractures [15].…”

Section: Introductionmentioning

confidence: 97%

Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study

Wang

Zhang

et al. 2019

Preprint

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Background The topic that whether the injured deltoid ligament should be repaired when associated with ankle joint fractures is still discussed. The objective of this study was to compare the clinical effect of open reduction and internal fixation (ORIF) with or without deltoid ligament repair (DLR) in treating supination-external rotation type IV (SER IV) ankle fractures. Methods Between January 2012 and December 2015, 43 patients were diagnosed as SER IV ankle fractures, 20 underwent ORIF and transarticular external fixation (TEF) without DLR (group 1), 23 were treated with ORIF and DLR (group 2). The pre- and post-operative radiographic examination were performed, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, the visual analog scale (VAS), the Medical Outcomes Short Form 36-item questionnaire score (SF-36), and the ankle range of motion (ROM) were used for functional evaluation. Results In both groups, the three scores improved significantly after surgery, but there was no significant difference between the two groups. At 6 weeks after surgery, patients in group 2 had better ankle ROM than group 1 (29.35 ± 2.033 vs. 40.35 ± 3.550, P < 0.001), but there was no difference at 12 months postoperatively. No cases of bone nonunion or post-traumatic arthritic changes were seen during the follow-up. Patients in group 1 required a shorter time to achieve fracture union than patients in group 2. Conclusions ORIF with TIF is an optional strategy to manage SER IV ankle fractures as it achieves comparable functional results to ORIF with DLR. It also allows patients to start relatively earlier weight-bearing and may promote fracture union.

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Early and mid-term results of transarticular external fixation in the treatment of supination-external rotation type IV equivalent ankle fractures

Cited by 5 publications

References 28 publications

Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study

Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study

Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study

Transarticular external fixation versus deltoid ligament repair in treating SER IV ankle fractures: a comparative study

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