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[article]
in The Foot > 34 (Mars 2018) . - p. 48-52
Titre : Ankle fractures: getting it right first time Type de document : article de périodique Auteurs : Victoria Sinclair ; [et al.] Année de publication : 2018 Article en page(s) : p. 48-52 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / chirurgie
[Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / thérapie
[Thésaurus Mesh]Fixateurs internes
[Thésaurus Mesh]Fractures de la chevilleMots-clés : ankle fractures internal fixators Résumé : Introduction
Ankle fractures are common injuries presenting to trauma departments and ankle open reduction and internal fixation (ORIF2) is one of the first procedures targeted in early orthopaedic training. Failure to address the fracture pattern with the appropriate surgical technique and hardware may lead to early failure, resulting in revision procedures or premature degenerative change. Patients undergoing revision ORIF are known to be at much greater risk of complications and many of these secondary procedures may be preventable.
Method
A retrospective analysis of all patients attending our unit for ankle ORIF over a two year period was undertaken. Patients were identified from our Bluespier database and a review of x-rays was undertaken. All patients undergoing re-operation within eight weeks of the primary procedure were studied. The cause of primary failure was established and potential contributing patient and surgical factors were recorded.
Results
236 patients undergoing ankle ORIF were identified. 13 patients (5.5%) returned to theatre for a secondary procedure within eight weeks. Within this group, seven (54%) patients returned for treatment of a neglected or under treated syndesmotic injury, three (23%) for complete failure of fixation, two (15%) with wound problems and one (8%) for medial malleolus mal-reduction. Of the patient group, five (39%) were known type 2 diabetics. Consultants performed two (15%) procedures, supervised registrars five (39%) and unsupervised registrars six (46%) operations.
Conclusion
Errors are being made at all levels of training in applying basic principles such as restoring fibula length and screening the syndesmosis intra-operatively. Appropriate placement and selection of hardware is not always being deployed in osteopenic bone resulting in premature failure of fixation and fracture patterns are not being fully appreciated. Patients are undergoing preventable secondary procedures in the operative treatment of ankle fractures.
En ligne : https://reader.elsevier.com/reader/sd/48ED778B7C48F39F82112143BB4B104E9250E9CC01 [...] Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité F Périodique Erasme - périodiques Périodiques Disponible F Périodique Erasme - périodiques Périodiques Disponible Distal Tibiofibular Malreduction in Ankle Fractures Received Fibula Plate and Syndesmotic Screw Fixation / Ali Yüce in Journal of the American Podiatric Medical Association, vol.113, 05 (Septembre 2023)
[article]
in Journal of the American Podiatric Medical Association > vol.113, 05 (Septembre 2023)
Titre : Distal Tibiofibular Malreduction in Ankle Fractures Received Fibula Plate and Syndesmotic Screw Fixation Type de document : article de périodique Auteurs : Ali Yüce ; Mustafa Yerli ; Yunus Imren ; Süleyman Semih Dedeoglu ; Haluk Cabuk ; Hakan Gürbüz Année de publication : 2023 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / chirurgie
[Thésaurus Mesh]Collecte de données
[Thésaurus Mesh]Fractures de la cheville
[Thésaurus Mesh]Période postopératoireMots-clés : Malréduction tibiofibulaire distale malréductions postopératoires vis syndesmotique plaque de péroné distal latéral anatomiquement verrouillée Résumé : Background: The aim of the study was to examine the effect of the position of the plate and syndesmotic screw on postoperative tibiofibular joint malreductions in cases where the syndesmotic screw is inserted through the hole of the anatomically locked lateral distal fibula plate.
Methods: Thirty patients (13 female and 17 male patients) with postoperative computed tomographic scans were examined retrospectively. Patient information (eg, tibiofibular congruence measured from postoperative computed tomographic scans, the anterior and posterior tibiofibular distance at axial sections, the presence and orientation of fibular rotation, the presence of tibiofibular intraarticular piece, the angle between the syndesmotic screw and incisural line, the placement of the plate, and the localization of the screw on the fibula in axial images) was recorded.
Results: Those with fibular internal rotation had a lower syndesmotic screw–incisural line angle (SIA) (P = .001).There was a very strong negative significant correlation between the tibiofibular angle and SIA (rho, −0.780; P = .001). The median tibiofibular angle was found to be higher in cases with the fibula plate placed anteriorly (P = .009).The median SIA was found to be lower in cases with the fibula plate placed anteriorly (P = .004).The rate of placement of syndesmotic screw in the anterior third of the fibula was found to be high in cases with the fibula plate placed anteriorly (P = .049).
Conclusions: In ankle fractures treated with insertion of a syndesmotic screw through the plate, the orientation of the syndesmotic screw in the axial plane and the position of the plate may be associated with the incidence of postoperative syndesmosis malreduction.Note de contenu :
Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Factors Affecting the Clinical Outcomes of Surgically Treated Ankle Fractures Associated with the Posterior Malleolar Fragment / Mehmet Kuyumcu in Journal of the American Podiatric Medical Association, vol. 111, 05 (septembre-octobre 2021)
[article]
in Journal of the American Podiatric Medical Association > vol. 111, 05 (septembre-octobre 2021)
Titre : Factors Affecting the Clinical Outcomes of Surgically Treated Ankle Fractures Associated with the Posterior Malleolar Fragment Type de document : article de périodique Auteurs : Mehmet Kuyumcu ; Emre Bilgin ; Hasan Bombacı Année de publication : 2021 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / chirurgie
[Thésaurus Mesh]Fractures de la chevilleMots-clés : malléole postérieure Résumé : Background
This study was performed to determine the factors that influence the clinical outcomes of surgically treated ankle fractures associated with the posterior malleolus (PM).
Methods
We evaluated 42 fractures of 42 patients. Posterior malleolus fracture size was calculated using computed tomography. Posterior malleolar fractures with a size less than 10% were left nonfixated. The decision for larger fragments was performed using fluoroscopy following the fixation of other components. If the joint was found to be congruent, the PM was left nonfixated. Otherwise, the PM was reduced and fixated. Clinical outcomes were evaluated based on Weber, Freiburg, and American Orthopaedic Foot and Ankle Society scores. Ankle osteoarthritis was determined according to the Canadian Orthopaedic Foot and Ankle Society classification. The effect of PM fixation, age, PM fragment size, waiting period before surgery, presence of ankle dislocation, and number of injured malleoli on clinical outcomes were assessed. Statistical significance was set at a value of P < .05.
Results
The mean patients age was 48.5 ± 14.9 years (range, 20–84 years) and the mean follow-up was 23.7 ± 8.6 months (range, 12–56 months). Fixation of the PM was performed solely in 12 patients. Postoperative displacement of the PM and articular step were less than 2 mm in all fractures. Statistically significant worse outcomes were demonstrated based on functional scores in the patients with a PM size greater than or equal to 25% (P = .042, P = .038, and P = .048, respectively) and in patients aged 60 years or older (P = .005, P = .007, and P = .018, respectively). However, there was no significant difference between functional scores and the other factors. Ankle osteoarthritis was observed at a higher rate in patients with PM size greater than or equal to 25% and in patients aged 60 years or older.
Conclusions
Clinical outcomes of the patients are mainly influenced by the patient's age and PM fragment size. However, if the tibiotalar joint is congruent, comparable results can be obtained in PM fixated or nonfixated patients.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Factors Affecting the Clinical Outcomes of Surgically Treated Ankle Fractures Associated with the Posterior Malleolar Fragment / Mehmet Kuyumcu in Journal of the American Podiatric Medical Association, vol.111,05 (septembre-octobre 2021)
[article]
in Journal of the American Podiatric Medical Association > vol.111,05 (septembre-octobre 2021)
Titre : Factors Affecting the Clinical Outcomes of Surgically Treated Ankle Fractures Associated with the Posterior Malleolar Fragment Type de document : article de périodique Auteurs : Mehmet Kuyumcu ; Emre Bilgin ; Hasan Bombacı Année de publication : 0021 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / chirurgie
[Thésaurus Mesh]Collecte de données
[Thésaurus Mesh]Fractures de la chevilleRésumé : Background
This study was performed to determine the factors that influence the clinical outcomes of surgically treated ankle fractures associated with the posterior malleolus (PM).
Methods
We evaluated 42 fractures of 42 patients. Posterior malleolus fracture size was calculated using computed tomography. Posterior malleolar fractures with a size less than 10% were left nonfixated. The decision for larger fragments was performed using fluoroscopy following the fixation of other components. If the joint was found to be congruent, the PM was left nonfixated. Otherwise, the PM was reduced and fixated. Clinical outcomes were evaluated based on Weber, Freiburg, and American Orthopaedic Foot and Ankle Society scores. Ankle osteoarthritis was determined according to the Canadian Orthopaedic Foot and Ankle Society classification. The effect of PM fixation, age, PM fragment size, waiting period before surgery, presence of ankle dislocation, and number of injured malleoli on clinical outcomes were assessed. Statistical significance was set at a value of P < .05.
Results
The mean patients age was 48.5 ± 14.9 years (range, 20–84 years) and the mean follow-up was 23.7 ± 8.6 months (range, 12–56 months). Fixation of the PM was performed solely in 12 patients. Postoperative displacement of the PM and articular step were less than 2 mm in all fractures. Statistically significant worse outcomes were demonstrated based on functional scores in the patients with a PM size greater than or equal to 25% (P = .042, P = .038, and P = .048, respectively) and in patients aged 60 years or older (P = .005, P = .007, and P = .018, respectively). However, there was no significant difference between functional scores and the other factors. Ankle osteoarthritis was observed at a higher rate in patients with PM size greater than or equal to 25% and in patients aged 60 years or older.
Conclusions
Clinical outcomes of the patients are mainly influenced by the patient's age and PM fragment size. However, if the tibiotalar joint is congruent, comparable results can be obtained in PM fixated or nonfixated patients.Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Fixation of Posterior Malleolar Fractures with Posterior Plating Through a Posterolateral Approach / Fırat Fidan in Journal of the American Podiatric Medical Association, vol. 111, 02 (Mars-avril 2021)
[article]
in Journal of the American Podiatric Medical Association > vol. 111, 02 (Mars-avril 2021)
Titre : Fixation of Posterior Malleolar Fractures with Posterior Plating Through a Posterolateral Approach Type de document : article de périodique Auteurs : Fırat Fidan ; Abdulkadir Polat ; Mehmet Umit Cetin ; Cengiz Kazdal ; Umut Yavuz ; Osman Lapcin ; Ufuk Ozkaya Année de publication : 2021 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / chirurgie
[Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / thérapie
[Thésaurus Mesh]Diagnostic par imagerie
[Thésaurus Mesh]Fractures de la cheville
[Thésaurus Mesh]Période postopératoire
[Thésaurus Mesh]Plaques orthopédiques
[Thésaurus Mesh]Procédures de chirurgie opératoire
[Thésaurus Mesh]TomodensitométrieMots-clés : fractures de la malléole postérieure classification de Haraguchi Résumé : Background: We aimed to evaluate radiologic and clinical outcomes of ankle fractures involving posterior fragments that were fixed with a posterior plate by the posterolateral approach. Methods: Sixty-five patients who were followed for at least 12 months and were older than 18 years were included. The posterior malleolus fractures were classified according to the Haraguchi classification system with computed tomography (CT). The posterior malleolus fragments were fixed with a plate through a posterolateral approach. Intraarticular step-off, reduction of the posterior malleolar fragment, and fibular position in the incisura were evaluated by early postoperative CT. American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analog scale pain score were used for clinical assessment. Results: The posterior malleolus fractures were classified as Haraguchi type 1 in 45 patients (69.2%), Haraguchi type 2 in 12 patients (18.5%), and Haraguchi type 3 in eight patients (12.3%). No patients showed signs of instability or loss of reduction on direct radiographs during follow-up. Postoperative CT showed no loss of reduction in the posterior malleolus and tibiofibular alignment. On evaluation, there was no intra-articular step-off (,1) in any of the patients. The mean AOFAS score was calculated to be 91.6. The mean visual analog scale score was 1.2. Conclusions: We conclude that direct posterior fixation with the posterolateral approach can be a good option for ankle fractures involving posterior malleolar fragments.
Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Impact of Posterior Malleolus Fixation on Clinical and Functional Results / Olgun Bingol in Journal of the American Podiatric Medical Association, vol. 113, 01 (Janvier 2023)
PermalinkKey insights on retrograde intramedullary fixation of distal fibular fractures / Ben Potter in Podiatry today, vol. 32, 1 (Janvier 2019)
PermalinkPostoperative Outcomes for Plate-Screw Fixation in Adolescent Patients with Ankle Fracture / Mehmet Ali Talmaç in Journal of the American Podiatric Medical Association, vol. 110, 06 (Novembre-décembre 2020)
PermalinkSurgical Treatment of Lateral Malleolar Fractures Using the Compression Cerclage System / Eren Cansü in Journal of the American Podiatric Medical Association, vol. 106, 5 (Septembre-octobre 2016)
PermalinkTreatment of Posterior Malleolar Fractures in Elderly Individuals with Kirschner Wire Tension Band Fixation / Bingqi Wang in Journal of the American Podiatric Medical Association, vol. 112, 04 (Juillet 2022)
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