Quality of Reduction of Posterior Malleolar Fractures: A CT-Based Case-Control Study Comparing AP-PA Screw Fixation vs Posterolateral Approach
| Autor: | Maximiliano Hube MD, Felipe Turner, Gonzalo F. Bastias MD, Martin Contreras, Patricio A. Fuentes, Jose Ignacio Quezada Morales MD |
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| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: | |
| Zdroj: | Foot & Ankle Orthopaedics, Vol 7 (2022) |
| Druh dokumentu: | article |
| ISSN: | 2473-0114 24730114 |
| DOI: | 10.1177/2473011421S00693 |
| Popis: | Category: Trauma; Ankle Introduction/Purpose: Classically, the standard of care in posterior malleolar fracture consisted in indirect reduction and percutaneous anteroposterior (AP) or posteroanterior (PA) fixation. There is a current trend to use a posterolateral approach (PL) for direct visualization of the fragment to obtain superior anatomical reduction. Comparative studies between both strategies of management have usually benefit the PL approach for obtaining superior articular reduction. Nonetheless, most of these studies are retrospective and tend to compare different group of fractures since percutaneous AP or PA groups are usually used for smaller fragments and PL for bigger PM fractures. There are no radiologic studies comparing the quality of reduction of AP-PA screws versus direct PL fixation on similar fracture-specific morphology and size patterns. Methods: A retrospective case-control study was performed including 228 trimalleolar ankle fractures treated in a level 1 trauma center between 2012 and 2021. Demographic and clinical data was obtained. Fractures were classified using the Bartonicek and Rammelt classification. The study group was conformed by 27 patients with PM fractures fixed with percutaneous AP-PA screws (PER). The control group was conformed by 27 patients matching the study group in terms of type of fracture morphology and age treated using a posterolateral approach (PL). Post operative ankle CT images were analyzed and quality of reduction was evaluated in both groups. Quality of reduction was defined according to the articular step-off, graded as excellent (less than 1 mm), satisfactory (1 to 2 mm) or poor (more than 2 mm) in sagittal and axial planes. Differences between groups was evaluated using Fisher's test with statistical significance defined as p |
| Databáze: | Directory of Open Access Journals |
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