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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 Fibular-lengthening osteotomy to correct a malunited ankle fracture using fresh-frozen femoral head allograft : a case study / Harry J. Visser in Journal of the American Podiatric Medical Association, vol. 107, 4 (Juillet- août 2017)
[article]
in Journal of the American Podiatric Medical Association > vol. 107, 4 (Juillet- août 2017) . - p. 319-323
Titre : Fibular-lengthening osteotomy to correct a malunited ankle fracture using fresh-frozen femoral head allograft : a case study Type de document : article de périodique Auteurs : Harry J. Visser, Auteur ; [et al.], Auteur Année de publication : 2017 Article en page(s) : p. 319-323 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / thérapie
[Thésaurus Mesh]Fractures de la cheville
[Thésaurus Mesh]Ostéotomie
[Thésaurus HELB]:Paramédical:Allongement fibulaireMots-clés : Fibular-lengthening osteotomy ankle fractures Résumé : Malreduction of a distal fibular fracture can lead to degenerative changes in the ankle joint. Previous studies have shown that the selective use of various fibular reconstructive osteotomies may halt the progression of degenerative arthritis by restoring the normal tibiotalar contact area and decreasing the stresses on the articular cartilage. In this case report, we achieved alignment with restoration of the talocrural angle and Shenton’s line of the ankle using a transfibular osteotomy and an allogeneic fresh-frozen femoral head graft to fill the resultant defect. The advantage of this procedure is twofold. First, fibularlengthening procedures may potentially decrease the eventual need for joint-sacrificing procedures such as an arthrodesis or arthroplasty. Second, an allograft allows for larger deficit correction without concern for donor-site morbidity. To our knowledge, this is the first case report using a fresh-frozen femoral head allograft for a fibular-lengthening osteotomy in the podiatric medical literature. Further research with larger patient populations is needed to establish whether fresh-frozen femoral head allograft is a reliable graft option for fibular-lengthening procedures Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité J Périodique Erasme - périodiques Périodiques Disponible 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 How Reliable Are Digital Radiographs for Evaluating Intraarticular Displacement in Ankle Epiphyseal Fractures Can Computed Tomography Be Eliminated? / Ali Turgut in Journal of the American Podiatric Medical Association, vol. 112, 06 (Novembre 2022)
[article]
in Journal of the American Podiatric Medical Association > vol. 112, 06 (Novembre 2022)
Titre : How Reliable Are Digital Radiographs for Evaluating Intraarticular Displacement in Ankle Epiphyseal Fractures Can Computed Tomography Be Eliminated? Type de document : article de périodique Auteurs : Ali Turgut ; Anıl Koca ; Ümit Altundag ; Mehmet Can Gezer ; Önder Kalenderer Année de publication : 2022 Langues : Anglais (eng) Descripteurs (mots clés) : [Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / diagnostic
[Thésaurus Mesh]:F:Fractures de la cheville:Fractures de la cheville / thérapie
[Thésaurus Mesh]Fractures de la cheville
[Thésaurus Mesh]Radiographie
[Thésaurus Mesh]TomodensitométrieMots-clés : fractures épiphysaires intra-articulaires du tibia distal Résumé : Background: The amount of intra-articular displacement of the fracture is the main issue when deciding the treatment method between conservative or surgical means in intra-articular fractures. In this study, we aimed to determine the intraobserver and interobserver reliability of measuring intra-articular displacement and to compare the digital radiographic and computed tomographic (CT) evaluations in distal tibia intra-articular epiphyseal fractures. Methods: Thirty-seven patients with digital radiography and CT scans were included in the study. Four sets were prepared with these images. Two of four sets were prepared as ankle radiographs, and the other two sets were prepared with CT scan views. Five observers were asked to measure the intra-articular displacement of the fractures in millimeters and also to make a decision between displacement amounts over or under 2 mm. Intraclass correlation coefficient scores were calculated for evaluation of intraobserver reliability, and Fleiss kappa values were calculated for interobserver reliability evaluations. A value greater than 0.75 was accepted as excellent agreement; 0.75 to 0.40 as intermediate to good agreement; and below 0.40 as poor agreement. Results: There were 15 Salter-Harris type 3, 13 Salter-Harris type 4, seven triplanar, and two Tillaux-Chaput fractures. Both intraobserver and interobserver reliabilities were slightly higher for CT scan evaluations. Amounts of displacement were found to be measured higher after CT scan evaluations other than radiographs. After the measurement of joint displacements on CT scans, it was observed that the measurements found below 2 mm on the digital radiograph measurement changed to greater than or equal to 2 mm in 16.4% of the patients. Conclusions: This study confirmed that digital radiographs cannot replace CT scans for the measurement of intra-articular displacement in ankle epiphyseal fractures. ( 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)
[article]
in Journal of the American Podiatric Medical Association > vol. 113, 01 (Janvier 2023)
Titre : Impact of Posterior Malleolus Fixation on Clinical and Functional Results Type de document : article de périodique Auteurs : Olgun Bingol ; Guzelali Ozdemir ; Taner Karlidag ; Alperen Korucu ; Niyazi Erdem Yasar ; Alper Deveci Année de publication : 2023 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]Étude comparative
[Thésaurus Mesh]Fractures de la chevilleMots-clés : vis plaque de renfort extérieur Résumé : Background: Clinical studies have shown that posterior malleolar fractures treated with a posterior buttress plate have improved outcomes compared to anterior-to-posterior screw fixation. The aim of this study was to evaluate the impact of posterior malleolus fixation on clinical and functional results. Methods: The patients with posterior malleolar fractures who were treated between January of 2014 and April of 2018 at our hospital were investigated retrospectively. Fifty-five patients included in the study were divided into three groups according to the fixation preferences of fractures (group I, posterior buttress plate; group II, anterior-to-posterior screw; and group III, nonfixated). The groups consisted of 20, nine, and 26 patients, respectively. These patients were analyzed according to demographic data, fixation preferences of fractures, mechanism of injury, hospitalization length of stay, surgical time, syndesmosis screw use, follow-up time, complications, Haraguchi fracture classification, van Dijk classification, American Orthopaedic Foot and Ankle Society score, and plantar pressure analysis. Results: There were no statistically significant differences between the groups in terms of gender, operation side, injury mechanism, length of stay, anesthesia types, and syndesmotic screw usage. However, when the age, follow-up time, operation time, complications, Haraguchi classification, van Dijk classification, and American Orthopaedic Foot and Ankle Society scores were evaluated, statistically significant differences were observed between the groups. Plantar pressure analysis data showed that group I yielded balanced pressure distribution between both feet compared to the other study groups. Conclusions: The posterior buttress plating of posterior malleolar fractures yielded better clinical and functional outcomes compared to the anterior-to-posterior screw fixation and nonfixated groups Permalink : https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= [article]Exemplaires
Cote Support Localisation Section Disponibilité aucun exemplaire Key insights on retrograde intramedullary fixation of distal fibular fractures / Ben Potter in Podiatry today, vol. 32, 1 (Janvier 2019)
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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