Periprosthetic fractures in total ankle replacement: classification system and treatment algorithm.

Background: Despite progress in implant design and surgical technique, the reported number of periprosthetic ankle fractures following total ankle joint replacement continues to increase. A treatment-oriented classification of these fractures has not yet been reported. The purpose of this study was...

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Publicado en:Journal of Bone & Joint Surgery, American Volume Vol. 95; no. 9; pp. 815 - 821
Autores principales: Manegold, Sebastian, Haas, Norbert P, Tsitsilonis, Serafim, Springer, Alexander, Märdian, Sven, Schaser, Klaus-Dieter
Formato: research Journal Article
Publicado: Lippincott Williams & Wilkins 5/1/2013
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 5/1/2013
      vid: 95
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      pub: Lippincott Williams & Wilkins
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        10.2106/JBJS.L.00572
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        atl: Periprosthetic fractures in total ankle replacement: classification system and treatment algorithm.
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        au:
          Manegold, Sebastian
          Haas, Norbert P
          Tsitsilonis, Serafim
          Springer, Alexander
          Märdian, Sven
          Schaser, Klaus-Dieter
        affil: Section for Foot and Ankle Surgery, Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, Berlin 13353, Germany. E-mail address for S. Manegold: sebastian.manegold@charite.de.
      sug:
        subj:
          Arthroplasty, Replacement, Ankle Adverse Effects
          Fractures Classification
          Periprosthetic Fractures
          Adult
          Aged
          Aged, 80 and Over
          Algorithms
          Female
          Human
          Male
          Middle Age
          Fractures Epidemiology
          Fractures Etiology
          Prevalence
          Young Adult
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Middle Aged: 45-64 years
          Female
          Male
      ab: Background: Despite progress in implant design and surgical technique, the reported number of periprosthetic ankle fractures following total ankle joint replacement continues to increase. A treatment-oriented classification of these fractures has not yet been reported. The purpose of this study was to evaluate the prevalence, cause, and location of periprosthetic fractures and the stability of the associated prosthetic components after total ankle replacement and to develop a method of classification.Methods: Data regarding 503 total ankle replacements with a mean follow-up of 14.7 months were reviewed. The prevalence, location, and possible cause of the fractures as well as prosthesis stability were analyzed and a systematic method of classification based on these factors was developed.Results: Twenty-one patients (4.2%) with a periprosthetic fracture were identified. The fracture was intraoperative (Type 1) in eleven patients (2.2%) and postoperative in the remaining ten (2.0%). Two of the latter fractures were traumatic (Type 2) and eight were stress fractures (Type 3). Two-thirds (fourteen) of the twenty-one fractures occurred in the medial malleolus.Conclusions: The prevalence of periprosthetic fractures following primary total ankle replacement was relatively low. We propose a classification system for these fractures that is based on more than 500 cases. We believe that this classification can facilitate therapeutic decision-making, as it allows for differential analysis of the cause and guides the choice among operative and nonoperative treatment options.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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