Splinting vs temporary external fixation in the initial treatment of ankle fracture-dislocations

Buyukkuscu, Mehmet Ozbey; Basılgan, Seçkin; Mollaomeroglu, Ali; Mısır, Abdülhamit; Başar, Hakan

doi:10.1016/j.fas.2021.03.018

Cited by 20 publications

(33 citation statements)

References 11 publications

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“…None of the patients in the external xator group developed loss of reduction, and only one patient (3.6%) developed super cial pin-site infection. Another study showed that 3 of 48 (6%) patients who suffered skin necrosis were external xated [7]. These results were consistent with our data; the rates of wound related complications were at a low level in the external xator group: one developed skin necrosis, and one developed a surgical wound infection.…”

Section: Discussionsupporting

confidence: 91%

“…Since 2019, percutaneous K-wire were used in our institution. Ankle fracture-dislocations were de ned as the presence of radiographic evidence of greater than 50% subluxation of the talus relative to the tibia at anteroposterior and lateral projections [6,7].…”

Section: Methodsmentioning

confidence: 99%

“…Similar to pilon fractures, two-stage treatment for ankle fracture-dislocations may help optimize surgical techniques, reduce the risk of skin damage from displaced fractures, and provide good functional results. External xators or splints for acute surgical treatment have been investigated [5][6][7]. However, recurrent dislocation of the ankle and infection or iatrogenic fracture through pin sites still remain very common and are one of the important reasons for the functional impact of ankle fracture-dislocations after surgery [8,9].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of temporary external and percutaneous k-wire fixations for treatment of ankle fracture–dislocations

Xie

Zhang

Cui

et al. 2023

Preprint

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Purpose Ankle fracture–dislocations are among the most severe injuries, and the use of an external fixator as a recommended fixation method has some disadvantages. The aim of this study was to compare the clinical outcomes and complication rates of external and K-wire fixations in the treatment of ankle fracture dislocations. Methods A total of 67 patients with ankle fracture–dislocations requiring temporary external or percutaneous K-wire fixation were included. The exclusion criteria were pilon fractures, open fractures, and those who required acute open reduction internal fixation (ORIF). The American Orthopaedic Foot and Ankle Society (AOFAS) ankle–hindfoot score, a 10-point visual analog scale (VAS) score (range 0–10), and complications before and after the definitive surgery were recorded. Results A significant difference between the two groups was not observed for age, sex, affected side, fracture type, smoking status, or diabetes. The average AOFAS scores were 83.2 and 83.3, the median VAS scores were 3 and 3, and the complication rates were 32.4% and 6.7% in the external and K-wire fixation groups, respectively (p = 0.010). However, skin necrosis, re-dislocation of the ankle, surgical wound infection, and posttraumatic ankle osteoarthritis frequency were not significantly different between the groups, except for pin-sites infection (p = 0.036). Conclusion Ankle fracture–dislocations using percutaneous k-wire fixation showed a low rate of complications and favorable clinical outcomes. This method could be a good alternative treatment option for ankle fracture-dislocations.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of temporary external and percutaneous k-wire fixations for treatment of ankle fracture–dislocations

Xie

Zhang

Cui

et al. 2023

Preprint

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“…Few studies have reported medium- or long-term results in fracture-dislocation of the ankle [ 9 , 11 , 12 , 16 ]. Warner et al [ 9 ] compared short-term functional outcomes in pronation external rotation ankle fractures with and without dislocation.…”

Section: Discussionmentioning

confidence: 99%

“…The authors concluded that fracture-dislocation occurred more frequently in patients who were older, female, and diabetic, and that the functional outcomes were generally poorer in comparison to ankle fractures without dislocation. Buyukkuscu et al [ 16 ] compared the efficacy, functional outcomes, and complication frequency of splinting and external fixation in the initial treatment of ankle fracture-dislocations with poor soft tissue conditions. Patients were divided into two groups based on whether they were treated with a splint ( n = 69) or an external fixator ( n = 48).…”

Section: Discussionmentioning

confidence: 99%

Clinical and Radiological Results after Fracture-Dislocations of the Ankle: A Medium- to Long-Term Followup Study

Luna

Caterini

Casci

et al. 2022

JFMK

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The authors report the long-term outcome in a series of 26 patients surgically treated for a fracture-dislocation of the ankle by open reduction and internal fixation (ORIF), reviewed after an average followup of 5.2 years. The average age of the patients was 46.8 years; 17 were female and 9 male; the right side was involved in 22 patients and the left side in 4; 10 patients had a unimalleolar fracture, 11 a bimalleolar fracture, and 5 a trimalleolar fracture. The quality of reduction was excellent in 14 cases and good in 12. The functional results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) score, while radiographic results followed the Van Dijk classification. At followup, the AOFAS score ranged from 75 to 98 points with an average of 87.9, while the radiographic results were evaluated as grade 0 in 16 ankles and grade I in 10. Fracture-dislocations of the ankle occurred more frequently after high-energy traumas in younger patients on the right side, but they were also observed in older females after low-energy trauma. Excellent reduction was correlated with better radiographic results at long term followup. However, these injuries may lead to a poor functional outcome, despite an anatomical reduction and good radiographic results; in fact, in nine of our cases (34.6 per cent), the AOFAS score was less than 90 points.

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Temporary immobilization methods for closed low-energy ankle fracture-dislocations: comparative analysis of a retrospective cohort

González-Morgado,

Bargalló-Granero,

Pujol

et al. 2024

Eur J Orthop Surg Traumatol

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Splinting vs temporary external fixation in the initial treatment of ankle fracture-dislocations

Cited by 20 publications

References 11 publications

Comparison of temporary external and percutaneous k-wire fixations for treatment of ankle fracture–dislocations

Comparison of temporary external and percutaneous k-wire fixations for treatment of ankle fracture–dislocations

Clinical and Radiological Results after Fracture-Dislocations of the Ankle: A Medium- to Long-Term Followup Study

Temporary immobilization methods for closed low-energy ankle fracture-dislocations: comparative analysis of a retrospective cohort

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