Nailing the fibula: alternative or standard treatment for lateral malleolar fracture fixation? A broken paradigm.
Purpose: Despite the fact that open reduction and internal fixation with a plate, either non-locked or locked, is the standard of care for managing lateral malleolus fractures, intramedullary (IM) fixation of the fibula has been recently introduced as an alternative, mainly for some potential compli...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 47; no. 6; pp. 1911 - 1921 |
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| Autores principales: | , , , , , , |
| Formato: | diagnostic images pictorial research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=153847181&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 153847181 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Dec2021 vid: 47 iid: 6 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 153847181 144009909 153847181 153847181 10.1007/s00068-020-01337-w 153847181 ppf: 1911 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Nailing the fibula: alternative or standard treatment for lateral malleolar fracture fixation? A broken paradigm. aug: au: Giordano, Vincenzo Boni, Guilherme Godoy-Santos, Alexandre Leme Pires, Robinson Esteves Fukuyama, Junji Miller Koch, Hilton A. Giannoudis, Peter V. affil: Serviço de Ortopedia e Traumatologia Prof. Nova Monteiro, Hospital Municipal Miguel Couto, Rua Mário Ribeiro 117/2º andar, Leblon, 22430-160, Rio de Janeiro, RJ, Brazil sug: subj: Ankle Fractures Surgery Fracture Fixation Methods Fibula Surgery Orthopedic Fixation Devices Human Surgical Patients Retrospective Design Record Review Treatment Outcomes Evaluation Multicenter Studies Case Studies Postoperative Period Postoperative Pain Physical Activity Functional Status Fibula Fractures Surgery Minimally Invasive Procedures Patient Safety Clinical Assessment Tools ab: Purpose: Despite the fact that open reduction and internal fixation with a plate, either non-locked or locked, is the standard of care for managing lateral malleolus fractures, intramedullary (IM) fixation of the fibula has been recently introduced as an alternative, mainly for some potential complicated situations. We hypothesized that almost all patterns of distal fibula fracture can be safely fixed with an IM device, with the potential benefit of providing biomechanical efficiency, but using a soft-tissue friendly implant. Here, we present a multicenter case series based on a proposed algorithm. Patients and methods: Sixty-nine consecutive patients were managed with fibular IM fixation for closed malleolar fractures. Twenty patients were managed by IM screw fixation and 49 by fibular nailing. Outcome was measured both according to the American Orthopaedic Foot and Ankle Society (AOFAS) score for ankle and hindfoot, and the time to bone union. Results: The mean AOFAS for Group I was 99.35 ± 1.95 points and that for Group II was 89.30 ± 16.98 points. There were no significant differences between the fracture pattern, according to the Lauge-Hansen classification, and post-operative levels of pain and functional activity among patients in both groups (p > 0.05). All fractures healed uneventfully in both groups. The mean time to union for Group I was 8.15 weeks and for Group II was 8.25 weeks (p > 0.05). Conclusion: In this multicenter case series, intramedullary fixation for the lateral malleolus fracture presented itself as a viable and safe option for the treatment of almost all patterns of fibula fracture in adults. Overall, we were able to demonstrate the potential indications of the proposed algorithm for the choice of IM implant for the lateral malleolus fracture in terms of the Lauge-Hansen staged classification. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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