Long‐term functional and radiographic outcomes in 243 operated ankle fractures

Verhage, Samuël Marinus; Schipper, I.B.; Hoogendoorn, J. M.

doi:10.1186/s13047-015-0098-1

Cited by 68 publications

(55 citation statements)

References 23 publications

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“…The ankle range of motion (ROM) was measured, and the difference of the dorsiflexion between the injured and uninjured side was calculated and presented as dorsiflexion restriction [19, 20]. Visual Analog Scale (VAS) was used to evaluate local pain.…”

Section: Methodsmentioning

confidence: 99%

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

Xiong

Chen

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct reduction technique through posterolateral approach or the indirect reduction technique using ligamentotaxis.MethodsPatients with a PMF involving over 25% of the articular surface were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group. Following reduction and fixation of the fracture, the quality of fracture reduction was evaluated in post-operative CT images. Clinical and radiological follow-ups were performed at 6 weeks, 3 months, 6 months, 12 months, and then at 6 month-intervals postoperatively. Functional outcome (AOFAS score), ankle range of motion, and Visual Analog Scale (VAS) were evaluated at the last follow-up. Statistical differences were compared between the DR and IR groups considering the patient demographics, quality of fracture reduction, AOFAS score, and VAS.ResultsTotally 116 patients were included, wherein 64 cases were assigned to the DR group and 52 cases were assigned to the IR group. The quality of fracture reduction was significant higher in the DR group (P = 0.038). In the patients who completed a minimum of 12 months’ follow-up, a median AOFAS score of 87 was recorded in the DR group, which was significantly higher than that recorded in the IR group (a median score of 80). The ankle range of motion was slightly better in the DR group, with the mean dorsiflexion restriction recorded to be 5.2° and 6.1° in the DR and IR group respectively (P = 0.331). Similar VAS score was observed in the two groups (P = 0.419).ConclusionsThe direct reduction technique through a posterolateral approach provide better quality of fracture reduction and functional outcome in the management of PMF over 25% of articular surface, as compared with the indirect reduction technique using ligamentotaxis.Trial registration NCT02801474 (retrospectively registered, June 2016, ClinicalTrails.gov).

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Section: Methodsmentioning

confidence: 99%

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

Xiong

Chen

et al. 2017

BMC Musculoskelet Disord

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“…According to Viberg B [24] paper after locking plate treatment a rate of complications was observed in 69% cases. We believe that absence of a foreign body in the proximity of the joint contributes to the absence of pain syndrome, which is proved by studies of some surgeons: Kruppa CG [12] -in 47.6% of all cases, according to Verhage SM [13] due to pain or discomfort removal of the implants took place in 29% participants after 13 months in average.…”

Section: Discussionmentioning

confidence: 92%

“…Among the surgical methods of fixing fractures of the ankle joint area and damaging of tibiofibular syndesmosis, there are a number of ways: by internal fixation (wires, plates, screws, intramedullary nailing) [4][5][6][7] and by different external fixators [8]. Unfortunately, complications can often be encountered, such as nonunion or mal-union of the bones [9][10][11][12], pseudoarthrosis, subluxations in the ankle [5], pain syndrome [12,13]. Cases of inflammation in the zone of intervention are common.…”

Section: Introductionmentioning

confidence: 99%

Ilizarov Technique in Acute Ankle Trauma: A Report of Fourth Cases

Tarchokov¹,

Leonchuk²

2017

Emerg Med

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Surgical treatment of patients with acute ankle trauma by transosseous osteosynthesis method was presented in the article. Malleolar fracture, injury of tibiofibular syndesmosis, subluxation in ankle joint and dislocation of foot were observed in our cases. Fracture of malleolus was described according to AO/OTA fracture classification in each case. In these patients we used osteosynthesis method by Ilizarov (original frame). Patients could load and use the operated limb in the Ilizarov fixator from the first days after the injury. The length of fixation of the limb by the Ilizarov fixator in the described cases was 45-58 days. In the presented clinical cases our approach in the treatment of this pathology is shown namely preference is given to closed fracture repositioning and elimination of subluxation/ dislocation without open access to bones and joints. Open access is possible with repeated attempts of closed reposition in the fixator or splintered fractures of the bones of the ankle joint. Initial range of motions in ankle joint in the described patients recovered in 4 weeks after removal of the Ilizarov fixator and training with a physiotherapist and massage therapist. Functional outcome was assessed using the American Orthopaedic Foot and Ankle Society (AOFAS), the American Academy of Orthopaedic Surgeons (AAOS) and VAS-pain scales. The goal of this paper is to show capabilities and our approach in closed reduction of malleolar fractures with injury of tibiofibular syndesmosis by Ilizarov technique.

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“…Se ha demostrado, que el tamaño del fragmento no es el único factor predictor del resultado (10,11) . Situaciones tales como el hundimiento de la superficie articular, la conminución y la estabilidad de la sindesmosis son también determinantes para conseguir un buen resultado clínico (1)(2)(3) .…”

Section: Introductionunclassified