The clinical outcome of combined distal third tibial and fibular fracture treatment with or without fibular fixation: A retrospective study

IF 0.3 Q4 ORTHOPEDICS

Archives of Trauma Research Pub Date : 2021-01-01 DOI:10.4103/atr.atr_62_20

Mohsen Khorrami, Payam Mohammadhoseini, Milad Vakilian, A. Khorrami, Yasaman Khorrami

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Abstract

Background and Objectives: Distal tibial and concomitant fibular fracture is a common fracture. Fibular fixation in conjugation with tibial fixation with a locking plate is controversial. This study aimed to determine the effect of fibular fixation in distal tibial fracture fixed with a distal medial locking plate. Methods: This retrospective study was conducted on 33 patients with mixed distal tibial and fibular fractures referred to the trauma centers of Golestan and Aria hospitals in Ahvaz, Iran, and underwent surgery between September 2018 and January 2019. The patients were categorized into Group I with fibular fixation (n = 17) and Group II without fibular fixation (n = 16). Then, they were divided into two subgroups according to the level of fibular fracture. For the subgroup (a), fracture was at 7.5 cm distal fibular (n = 11) and for the subgroup (b), proximal to group “a” at distal third (n = 6). Data were collected by asking patients about their function and pain in daily activities and performing examination and radiographs 6 months postoperatively. The assessment of the ankle was performed using the AOFAS. Data were analyzed using Chi-square and t-test by the SPSS version 26. Results: Six months post operation, there were no cases of malunion or wound complication in both groups. There was an osteomyelitis case in Group II, but none in Group I. There were six nonunions in total: two in Group I and four in Group II (P = 0.325). Furthermore, AOFAS was significantly greater in Group I compared to Group II (76.18 ± 17.45 vs. 50.62 ± 18.88, P < 0.001). Conclusions: According to the findings of the present study, there is a positive and crucial relationship between fibular fixation and AOFAS in ankles with the combined distal third tibial and fibular fracture. There are no crucial differences in nonunion of tibia, malunion, wound complication, deep infection, and osteomyelitis between nonfixation and fibular fixation.

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带或不带腓骨内固定治疗胫腓骨远端第三骨折的临床疗效：回顾性研究

背景与目的：胫骨远端伴腓骨骨折是一种常见的骨折。腓骨内固定与带锁定钢板的胫骨内固定结合是有争议的。本研究旨在确定远端内侧锁定钢板固定胫骨远端骨折的腓骨内固定效果。方法：这项回顾性研究对33名在2018年9月至2019年1月期间接受手术的伊朗阿瓦兹Golestan和Aria医院创伤中心就诊的胫骨远端和腓骨混合骨折患者进行。将患者分为有腓骨固定的I组（n=17）和无腓骨固定的II组（n=16）。然后，根据腓骨骨折的程度将他们分为两个亚组。对于亚组（a），骨折发生在腓骨远端7.5cm处（n=11），而对于亚组“a”的近端骨折发生在远端三分之一处（n=6）。通过询问患者日常活动中的功能和疼痛，并在术后6个月进行检查和射线照相来收集数据。使用AOFAS对踝关节进行评估。数据采用卡方检验和SPSS 26版的t检验进行分析。结果：术后6个月，两组均未出现畸形愈合或伤口并发症。第二组有1例骨髓炎，但第一组没有。共有6例不愈合：第一组2例，第二组4例（P=0.325）。此外，与第二组相比，第一组的AOFAS显著增加（76.18±17.45 vs.50.62±18.88，P<0.001）。结论：根据本研究的结果，腓骨内固定和踝关节第三胫腓骨联合骨折的AOFAS之间存在着积极而关键的关系。非固定和腓骨固定在胫骨不连、畸形愈合、伤口并发症、深部感染和骨髓炎方面没有显著差异。

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来源期刊

Archives of Trauma Research ORTHOPEDICS-

自引率

0.00%

发文量

审稿时长

25 weeks

期刊介绍： The journal will cover technical and clinical studies related to health, ethical and social issues in all fields related to trauma or injury. Archives of Trauma Research is an authentic clinical journal, which is devoted to the particular compilation of the latest worldwide and interdisciplinary approach and findings, including original manuscripts, meta-analyses and reviews, health economic papers, debates, and consensus statements of clinical relevant to the trauma and injury field. Readers are generally specialists in the fields of general surgery, neurosurgery, orthopedic surgery, plastic and reconstructive surgery, or any other related fields of basic and clinical sciences..