A prospective trial comparing operative and manipulative treatment of ankle fractures

Rowley, DI; Norris, SH; Duckworth, T.

doi:10.1302/0301-620x.68b4.3090049

Cited by 47 publications

(41 citation statements)

References 2 publications

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“…One arthroscopic study found 79% of patients to have some degree of chondral injuries, especially in patients with Weber C fractures/Pronation external rotation injuries [50]. Although some degree of stiffness is to be anticipated, most patients resume full activities following healing of these fractures [3] [47] [48].…”

Section: Prognosismentioning

confidence: 99%

Ankle Fractures: A Literature Review of Current Treatment Methods

Singh¹,

Kamal²,

Roulohamin³

et al. 2014

OJO

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Ankle fracture is one of the most common lower limb fractures for they account for 9% of all fractures representing a significant portion of the trauma workload. Ankle fractures usually affect young men and older women, however, below the age of 50; ankle fractures are the commonest in men. Two commonly used classification systems for ankle fractures include the danis weber AO classification and the Lauge-Hansen classification. There is biomechanical evidence that posterior non-locking plates are superior in stability than laterally placed plates; however there is little clinical evidence. There are several different methods of ankle fracture fixation, however the goal of treatment remains a stable anatomic reduction of talus in the ankle mortise and correction of the fibula length as a 1 mm lateral shift of the talus in the ankle mortise reduces the contact area by 42%, and displacement (or shortening) of the fibula more than 2 mm will lead to significant increases in joint contact pressures. Further research both biomechanically and clinically needs to be undertaken in order to clarify a preferable choice of fixation.

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Section: Prognosismentioning

confidence: 99%

Ankle Fractures: A Literature Review of Current Treatment Methods

Singh¹,

Kamal²,

Roulohamin³

et al. 2014

OJO

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“…Some studies have compared outcomes of surgically and nonsurgically managed displaced ankle fractures where satisfactory closed reduction was possible. 1,16,22,24 While the results vary, the majority of these studies found better outcomes when surgical fixation was used.…”

Section: Broos and Bisschopmentioning

confidence: 99%

Prediction of Outcome After Ankle Fracture

Hancock

Herbert²,

Stewart³

2005

J Orthop Sports Phys Ther

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Mark Stewart, MPH (Hons)3Study Design: Prospective inception cohort study of 62 consecutive patients seen in 2 orthopaedic clinics following ankle fracture. Objectives: To investigate 4 putative predictors (age, fracture classification, acute management [surgical or nonsurgical], and ankle dorsiflexion range of motion measured at the time of cast removal) of outcome after ankle fracture and to develop simple predictive models of outcome after ankle fracture. Background: Ankle fracture is a common condition. However, few studies have investigated factors that predict outcome after ankle fracture. Methods and Measures: Sixty-two consecutive subjects aged 17 or older with ankle fractures were recruited from 2 hospital orthopaedic clinics. Outcome measures recorded at 6 weeks and 6 months after cast removal included 2 functional questionnaires, patients' ratings of global improvement, and a measure of ankle dorsiflexion. The predictive value of 4 variables selected a priori was analyzed using bivariate and stepwise multiple linear regression. Results: Ankle dorsiflexion and fracture classification predicted outcome 6 weeks and 6 months after cast removal for all outcome measures used (P Ͻ .05, r 2 = 0.09-0.47). Fracture management (surgical or nonsurgical) inconsistently predicted outcome at both 6 weeks and 6 months, and age did not predict outcome at either 6 weeks or 6 months after cast removal. The predictive models explain between 19% and 58% of the variance in outcomes 6 weeks after cast removal and 19% to 52% of the variance in outcomes 6 months after cast removal. Conclusion: Ankle dorsiflexion measured at the time of cast removal and fracture classification are clinically significant predictors of outcome after ankle fracture; however, much unexplained variation in outcomes still exists. J Orthop Sports Phys Ther 2005;35:786-792.

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“…Choć wcze sne wy ni ki za cho waw cze go le cze nia zła mań nie sta bil nych ko stek go le ni wy da ją się być po rów ny wal ne z le cze niem ope ra cyj nym, to pi śmien -nic two jed no znacz nie wska zu je na nie za do wa la ją ce wy ni ki od le głe, pre fe ru jąc ope ra cyj ną re po zy cję i stabi li za cję odła mów kost nych [25][26][27][28]. W pra cy Twar dosza i wsp., któ ry przed sta wił od le głe wy ni ki le cze nia za cho waw cze go, nie uzy ska no lub nie utrzy ma no anato micz ne go na sta wie nia odła mów w opa trun ku gip sowym w po nad 30% przy pad ków, a po ło wa pa cjen tów le czo nych z po wo du zła mań trój -i dwu kost ko wych ska rży ła się na prze trwa łe do le gli wo ści bó lo we [28].…”

Section: Discussionunclassified

“…Although short-term results of conservative treatment in unstable ankle fractures appear to be comparable with surgical outcomes, the literature clearly indicates unsatisfactory long-term results and a preference for operative reduction and stabilisation of bone fragments [25][26][27][28]. Twardosz et al pre sent ed long-term results of conservative treatment, reporting failure to obtain or maintain anatomic re duction of bone fragments in a plaster cast in more than 30% of the subjects.…”

Section: Discussionmentioning

confidence: 99%

Methods of Diagnosis and Treatment of Ankle Fractures - The Opinion of Members and Supporters of the Polish Foot and Ankle Society

Kołodziej

Napiontek²

2011

Ortopedia, traumatologia, rehabilitacja

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STRESZCZEnIEWstęp. Pra cę opar to na wy ni kach ba da nia an kie to we go prze pro wa dzo ne go wśród uczest ni ków III Kon gresu Pol skie go To wa rzy stwa Sto py i Sta wu Sko ko wo -Go le nio we go (Po lish Fo ot and An kle So cie ty -PF&AS), któ ry od był się w Ja star ni w dniach 22-24 kwiet nia 2010 ro ku.Ma te riał i me to dy. Wy ko rzy sta no opis kli nicz ny i ob raz ra dio lo gicz ny hi po te tycz ne go pa cjen ta, z ty po wym zła ma niem ko stek go le ni, aby okre ślić spo so by dia gno sty ki i le cze nia tych ura zów sto so wa ne w Pol sce. Uczestni ka mi ba da nia by li le ka rze or to pe dzi. Roz pro wa dzo no 85 an kiet, na któ re uzy ska no 54 od po wie dzi (63%).Wy ni ki i Wnio ski. Więk szość an kie to wa nych: roz po zna ła wła ści wy me cha nizm zła ma nia, roz po zna ła typ zła ma nia, pre fe ro wa ła le cze nie ope ra cyj ne, ale nie po tra fi ła za sto so wać kla sy fi ka cji AO. Od po wie dzi na te mat kon tro li ra dio lo gicz nej po ope ra cji nie uwzględ nia ły dłu gie go cza su ob ser wa cji, a pro po no wa ne me to dy ob razo wa nia uszko dzeń wię zo zro stu pisz cze lo wo -strzał ko we go na le ży uznać za nie wy star cza ją ce. Po da ny w od powie dziach czas i sto pień ob cią ża nia koń czy ny po ope ra cji mie ścił się w stan dar dzie po stę po wa nia. Pro po zy cje pro fi lak ty ki prze ciw za krze po wej rów nież od po wia da ły przy ję tym stan dar dom Słowa kluczowe: złamania kostek goleni, więzozrost piszczelowo-strzałkowy, leczenie operacyjne SUMMARYBackground. The present paper is based on a survey distributed among the participants of the 3rd Congress of the Polish Foot and Ankle Society in Jastarnia on April 22-24, 2010.Material and methods. A clinical description and imaging data of a hypothetical patient with a typical ankle fracture were used to identify current methods of diagnosis and treatment of such injuries in Poland. The participants were orthopaedists. Eighty-five questionnaires were distributed and 54 (63%) were completed and returned.Results and Conclusions. Most respondents correctly recognized the fracture mechanism and identified the type of fracture. They preferred operative treatment, but were not able to apply the AO classification. The answers regarding post-operative radiological follow-up did not provide for long-term follow-up and the suggested methods of imaging to detect disruption of the tibiofibular syndesmosis were insufficient. The recommendations concerning the timing and staging of post-operative weight bearing as well as antithrombotic prophylaxis complied with current standards.

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A prospective trial comparing operative and manipulative treatment of ankle fractures

Cited by 47 publications

References 2 publications

Ankle Fractures: A Literature Review of Current Treatment Methods

Ankle Fractures: A Literature Review of Current Treatment Methods

Prediction of Outcome After Ankle Fracture

Methods of Diagnosis and Treatment of Ankle Fractures - The Opinion of Members and Supporters of the Polish Foot and Ankle Society

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