A Novel Operative Approach to the Treatment of Posterior Malleolus Fractures

IF 0.1 Q4 ORTHOPEDICS
E. Fahey, Shane P. Russell, C. Ní Fhoghlu, Niamh Curran, T. Bayer, J. McKenna
{"title":"A Novel Operative Approach to the Treatment of Posterior Malleolus Fractures","authors":"E. Fahey, Shane P. Russell, C. Ní Fhoghlu, Niamh Curran, T. Bayer, J. McKenna","doi":"10.1097/BTF.0000000000000350","DOIUrl":null,"url":null,"abstract":"Background: Posterior malleolar fractures are a common subtype of ankle fractures. The management of these fractures remains controversial, though there has been a move toward more operative management in recent years. The operative approach most commonly used to treat these fractures is posterolateral. This method has several drawbacks including the amount of retraction required on already traumatized skin, the risk of damaging the posterior interosseous tibio-fibular ligament, and the difficulty visualizing both the distal fibular and posterior malleolar fractures. We describe a novel operative approach for visualizing and treating these fractures and report on our results. Method: This was a retrospective review of prospectively collected data. Data from 2 orthopedic trauma units where this technique is used was analyzed. Demographic and radiographic data was recorded, and a chart review was conducted to identify any noted complications. Results: On analysis of medical records, 50 patients were identified who had been operated on using this technique. When classified using the Bartonicek classification, 46% were type II, 36% were type III and 18% were type IV. Analysis of final x-rays showed that there was no incidence of implant failure or loss of reduction in this cohort. There were 2 complications recorded: 1 early wound dehiscence and 1 late infection giving an overall complication rate of 4%. Discussion: The technique described in this paper is a novel approach, which we feel offers several benefits. We demonstrated that this technique is safe with an incidence of early complications lower than figures commonly quoted for standard care of this cohort of patients. Level of Evidence: Level IV—case series","PeriodicalId":44146,"journal":{"name":"Techniques in Foot and Ankle Surgery","volume":"21 1","pages":"228 - 232"},"PeriodicalIF":0.1000,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Foot and Ankle Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/BTF.0000000000000350","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Posterior malleolar fractures are a common subtype of ankle fractures. The management of these fractures remains controversial, though there has been a move toward more operative management in recent years. The operative approach most commonly used to treat these fractures is posterolateral. This method has several drawbacks including the amount of retraction required on already traumatized skin, the risk of damaging the posterior interosseous tibio-fibular ligament, and the difficulty visualizing both the distal fibular and posterior malleolar fractures. We describe a novel operative approach for visualizing and treating these fractures and report on our results. Method: This was a retrospective review of prospectively collected data. Data from 2 orthopedic trauma units where this technique is used was analyzed. Demographic and radiographic data was recorded, and a chart review was conducted to identify any noted complications. Results: On analysis of medical records, 50 patients were identified who had been operated on using this technique. When classified using the Bartonicek classification, 46% were type II, 36% were type III and 18% were type IV. Analysis of final x-rays showed that there was no incidence of implant failure or loss of reduction in this cohort. There were 2 complications recorded: 1 early wound dehiscence and 1 late infection giving an overall complication rate of 4%. Discussion: The technique described in this paper is a novel approach, which we feel offers several benefits. We demonstrated that this technique is safe with an incidence of early complications lower than figures commonly quoted for standard care of this cohort of patients. Level of Evidence: Level IV—case series
一种治疗后踝骨折的新手术入路
背景:后踝骨折是踝关节骨折的常见亚型。这些骨折的治疗仍然存在争议,尽管近年来手术治疗的趋势越来越明显。治疗这些骨折最常用的手术入路是后外侧。这种方法有几个缺点,包括在已经受伤的皮肤上需要大量的回缩,损伤后骨间胫腓骨韧带的风险,以及难以观察腓骨远端和后踝骨折。我们描述了一种新的手术方法来观察和治疗这些骨折,并报告了我们的结果。方法:对前瞻性收集的资料进行回顾性分析。我们分析了使用该技术的2个骨科创伤单位的数据。记录了人口统计学和放射学数据,并进行了图表回顾以确定任何注意到的并发症。结果:通过对病历的分析,确定了50例使用该技术进行手术的患者。当使用Bartonicek分类时,46%为II型,36%为III型,18%为IV型。最终x射线分析显示,该队列中没有植入物失败或复位丢失的发生率。术后并发症2例,早期创面裂开1例,晚期感染1例,总并发症发生率为4%。讨论:本文中描述的技术是一种新颖的方法,我们认为它提供了几个好处。我们证明了这种技术是安全的,早期并发症的发生率低于通常引用的标准护理这组患者的数字。证据级别:iv级病例系列
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
0.40
自引率
0.00%
发文量
18
期刊介绍: Techniques in Foot & Ankle Surgery offers a unique opportunity to master the most innovative and successful surgical techniques for correction of foot and ankle disorders. Featuring contributions from the world"s foremost orthopaedic surgeons and podiatrists, this quarterly journal supplies step-by-step details on these techniques. The contributors explain the rationale, indications, and contraindications for each procedure, identify the pitfalls and potential complications, and provide invaluable tips for improving results. The journal is illustrated cover to cover with intraoperative photographs and drawings, including several in full color.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信