A fibular notch approach for the treatment of ankle fractures involving the distal tibial plafond

Autor: Yiheng Cheng, Wenqing Qu, Tong Liu
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Male
Syndesmosis
lcsh:Diseases of the musculoskeletal system
medicine.medical_treatment
Radiography
Surgical approach
Osteoarthritis
Fracture Fixation
Internal
0302 clinical medicine
lcsh:Orthopedic surgery
Orthopedics and Sports Medicine
030212 general & internal medicine
Ankle Injuries
030222 orthopedics
medicine.diagnostic_test
Middle Aged
medicine.anatomical_structure
Treatment Outcome
Female
Research Article
musculoskeletal diseases
Adult
medicine.medical_specialty
Physical examination
Ankle Fractures
03 medical and health sciences
Young Adult
Pilon fractures
Fibular notch
medicine
Humans
Reduction (orthopedic surgery)
Retrospective Studies
Distal tibial plafond fractures
Tibia
business.industry
Multiple Trauma
medicine.disease
Surgery
Tibial Fractures
lcsh:RD701-811
Fibula
Orthopedic surgery
Feasibility Studies
Ankle
lcsh:RC925-935
business
Tomography
X-Ray Computed
Follow-Up Studies
Zdroj: Journal of Orthopaedic Surgery and Research
Journal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-8 (2021)
ISSN: 1749-799X
Popis: Background Although efficacy is related to many factors, the surgical approach is one of the most important intervention factors for complex ankle fractures. Ankle fractures involving the distal tibial plafond frequently present a surgical challenge in choosing which incisions will be best for surgical treatment. Here, we present an innovative fibular notch approach for the treatment of some specific ankle fractures and present a series of patients with either functional or radiographic outcomes. Methods Twenty-two patients with distal tibial plafond fractures with concomitant fibular and distal tibiofibular syndesmosis injuries were treated through a fibular notch approach in this retrospective study. The details of the surgical technique were reviewed from the operative notes. Relevant data were reviewed from the medical records. The quality of fractures and syndesmosis reduction was examined using CT scans, and lateral stability of the ankle was assessed by physical examination and stress radiographs. The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale (AOFAS) score was implemented for clinical functional assessment. Results All surgeries were successfully performed via the fibular notch approach as the primary approach with excellent intraoperative visualization. Postoperative radiography revealed satisfying restoration of all fractures and syndesmosis. All fractures healed with an average time of 17.3 ± 3.6 weeks. Mild posttraumatic osteoarthritis (PTOA) was present in 4 patients. The average AOFAS score was 88.8 at the last follow-up. Conclusions The fibular notch approach is a safe and reliable approach for the treatment of specific ankle fractures involving the distal tibial plafond. This approach provides excellent direct visualization of the fragments and articular surface without significantly increasing iatrogenic injuries. Satisfactory radiographic and clinical results were observed, and further clinical and anatomical studies are recommended to ascertain the feasibility of this approach in the treatment of complex distal tibial fractures.
Databáze: OpenAIRE
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