Percutaneous Fixation of Posterior Malleolar Fractures in Patients With Unstable Ankle Fractures Treated With a Fibular Intramedullary Nail: A Description of a Technique and Review of Outcomes
| Autor: | Thomas H Carter, Andrew D. Duckworth, Timothy O White, Sarah J Wordie, Deborah MacDonald |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Percutaneous Arthrodesis medicine.medical_treatment Bone Nails Ankle Fractures law.invention Intramedullary rod Fracture Fixation Internal law Fracture fixation medicine Humans Orthopedics and Sports Medicine Fixation (histology) Aged Retrospective Studies Aged 80 and over business.industry Soft tissue General Medicine Middle Aged Surgery medicine.anatomical_structure Treatment Outcome Patient-reported outcome Ankle business |
| Zdroj: | Wordie, S J, Carter, T H, MacDonald, D, Duckworth, A D & White, T O 2021, ' Percutaneous fixation of posterior malleolar fractures in patients with unstable ankle fractures treated with a fibular intramedullary nail : a description of a technique and review of outcomes ', Journal of orthopaedic trauma . https://doi.org/10.1097/BOT.0000000000002262 |
| ISSN: | 1531-2291 |
| Popis: | OBJECTIVES: (1) To describe the percutaneous technique used to reduce and fix a posterior malleolar fracture with anteroposterior (AP) screws in patients managed with a fibular intramedullary nail, (2) describe the selection of patients to whom this technique can be applied, and (3) report the clinical and patient reported outcome of this intervention.DESIGN: Retrospective review.SETTING: Academic orthopaedic trauma center.PATIENTS: Thirty-two consecutive patients with a mean age of 65 years (range, 39-90) over a thirteen-year period identified from a prospective database.INTERVENTION: Unstable ankle fractures managed surgically with a fibular nail and percutaneous fixation of the posterior malleolar component.MAIN OUTCOME MEASUREMENTS: The primary short-term outcome was complications related to posterior malleolar fracture fixation. The primary mid-term outcome was the Olerud-Molander Ankle Score (OMAS). Secondary outcomes included the Manchester-Oxford Foot Questionnaire (MOXFQ), EuroQol-5D (EQ-5D), health, pain and satisfaction.RESULTS: Thirty of the 32 (94%) posterior malleolar fractures united uneventfully. Post-operative loss of talar reduction occurred in two patients (6.3%), which in one patient (3.1%) eventually required a hindfoot nail arthrodesis. There were no soft tissue complications related to the AP screws or the fibular nail fixation. At a mean follow-up of 3.7 years (range, 1-8) the median OMAS, MOXFQ, EQ-5D, health, pain and satisfaction scores were 80.0, 23.4, 0.85, 80.0, 85.0 and 87.5 respectively.CONCLUSION: Percutaneous ankle fracture fixation with a fibular nail and posterior malleolar screws results in reliable fracture stabilisation, good patient outcomes and high treatment satisfaction.LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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