Application of a Ni-Ti arched shape-memory connector in unstable lateral malleolus fractures: A retrospective study.

Purpose: To compare the outcomes of the arched shape-memory connector (ASC) only fixation and the lateral one-third tubular plate fixation in managing unstable Type A or B lateral malleolus fractures according to the Weber (AO) classification, and to evaluate the feasibility and reliability of ASC o...

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Publicado en:Injury Vol. 50; no. 2; pp. 551 - 558
Autores principales: Hao, Zi-Chen, Xia, Yan, Wu, Jiang-Hong, Zhang, Yun-Tong, Xu, Shuo-Gui
Formato: research Journal Article
Publicado: Elsevier B.V. Feb2019
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2019
      vid: 50
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      pub: Elsevier B.V.
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        10.1016/j.injury.2018.10.037
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        atl: Application of a Ni-Ti arched shape-memory connector in unstable lateral malleolus fractures: A retrospective study.
      aug:
        au:
          Hao, Zi-Chen
          Xia, Yan
          Wu, Jiang-Hong
          Zhang, Yun-Tong
          Xu, Shuo-Gui
        affil: Department of Emergency, Trauma Center, Changhai Hospital, The Second Military Medical University, Shanghai, People's Republic of China
      sug:
        subj:
          Ankle Fractures Surgery
          Fracture Healing Physiology
          Ankle Joint Surgery
          Fracture Fixation
          Joint Instability Prevention and Control
          Human
          Ankle Joint
          Pilot Studies
          Reproducibility of Results
          Adult
          Ankle Fractures Physiopathology
          Ankle Fractures
          Radiography
          Treatment Outcomes
          Female
          Retrospective Design
          Ankle Joint Physiopathology
          Range of Motion Physiology
          Young Adult
          Middle Age
          Fracture Fixation Methods
          Male
          Bone Screws
          Validation Studies
          Comparative Studies
          Evaluation Research
          Multicenter Studies
          Clinical Assessment Tools
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Purpose: To compare the outcomes of the arched shape-memory connector (ASC) only fixation and the lateral one-third tubular plate fixation in managing unstable Type A or B lateral malleolus fractures according to the Weber (AO) classification, and to evaluate the feasibility and reliability of ASC only fixation in treating these fractures.Methods: From January 2010 to January 2015, 148 patients with Type A or B (Weber (AO) classification) lateral malleolus fractures treated with the arched shape-memory connector (ASC) only fixation or lateral plate fixation were included. There were 66 patients in the ASC only fixation group and 82 patients in the lateral plate group. Intergroup differences were absent regarding patient and fracture characteristics. The incision length, complete-union time, major complications and complaints, incidence of hardware removal, and final radiographic and functional evaluations were compared.Results: The follow-up time averaged 18.2 months in the ASC fixation group and 17.2 months in the lateral plate group. The ASC only fixation group had significantly decreased wound infection (4.55% versus 14.63%) and skin necrosis (none versus 7.32%). Of patients who underwent ASC only fixation 3.03% reported lateral ankle pain, 7.58% received palpable hardware, and 3.03% reported hardware irritation, while the corresponding observations in the lateral plate group were 19.51%, 54.88%, and 14.63%, respectively, representing a statistical difference. Furthermore, compared with the lateral plate group, the incidence of hardware removal was markedly lower in the ASC fixation group (12.12% versus 30.49%). In terms of reduction accuracy, complete-union time, and AOFAS scores, no appreciable differences were observed.Conclusions: ASC only fixation is a reliable alternative for managing Type A or B lateral malleolus fractures, leading to fewer soft tissue complications, fewer hardware complaints, and a reduced need for hardware removal, and a reduced need for hardware removal. In addition, ASC can be used for augmented plate fixation in certain comminuted fracture patterns.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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