Intramedullary Screw Fixation Versus Traditional Plating for Distal Fibula Fractures.

Autor: McClure TT; Department of Orthopedic Surgery, OhioHealth, Columbus, OH. Electronic address: tannertmcclure@gmail.com., Taylor BC; Orthopaedic Trauma and Reconstructive Surgery, Department of Orthopedic Surgery, Grant Medical Center, Columbus, OH., Huber G; Ohio University Heritage College of Osteopathic Medicine, Athens, OH., Glazier M; Department of Orthopedic Surgery, OhioHealth, Columbus, OH., Myers DM; Department of Orthopedic Surgery, OhioHealth, Columbus, OH., DeGenova DT; Department of Orthopedic Surgery, OhioHealth, Columbus, OH.
Jazyk: angličtina
Zdroj: The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons [J Foot Ankle Surg] 2023 Mar-Apr; Vol. 62 (2), pp. 355-359. Date of Electronic Publication: 2022 Sep 21.
DOI: 10.1053/j.jfas.2022.09.003
Abstrakt: The traditional method of treating fibular fractures in unstable ankle injuries involves open reduction and internal fixation with a plate and screw construct. Less invasive percutaneous fixation techniques with intramedullary fibular screws have been utilized for many years to reduce wound and implant complications while maintaining a stable ankle mortise. However, there have been no direct case-control studies comparing percutaneous intramedullary fibular screw fixation to the traditional open reduction and internal fixation with plates and screws. In our study, we compared radiographic and clinical outcomes for unstable ankle fractures in which the fibula fracture was treated with either a percutaneous intramedullary screw or by open reduction and internal fixation with a plate and screw construct. We retrospectively reviewed 69 consecutive patients from 2011 to 2019 with unstable ankle fractures treated with intramedullary fibular screws and compared them to 216 case-control patients treated with traditional plate and screw construct over the same time period. The average follow-up for the intramedullary screw group was 11.5 months and 15.2 months for the plate and screw group. We collected general demographic data, measured intraoperative and final follow-up talocrural angles, Kellgren-Lawrence osteoarthritis grade, union rates, implant removal rates, infection rates, and American Orthopedic Foot and Ankle Society ankle-hindfoot scores. The intramedullary screw group had a statistically significant lower rate of delayed implant removal (8.7% vs 23.6%) and there was no detectable difference in other measures.
(Copyright © 2022 the American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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