Comparison of different locking plate fixation methods in lateral malleolus fractures

Bilgetekin, Yenel Gürkan; Çatma, Mehmet Faruk; Öztürk, Alper; Ünlü, Serhan; Ersan, Önder

doi:10.1016/j.fas.2018.01.004

Cited by 18 publications

(24 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Eleven studies were considered suitable for inclusion in this systematic review and meta-analysis. 4,7,8,11,12,17,20,21,25,26,28 Ten of the included studies were retrospective cohort studies. 4,7,8,11,12,17,20,21,25,26 One of the included studies was a randomized controlled trial.…”

Section: Searchmentioning

confidence: 99%

“…4,7,8,11,12,17,20,21,25,26,28 Ten of the included studies were retrospective cohort studies. 4,7,8,11,12,17,20,21,25,26 One of the included studies was a randomized controlled trial. 28…”

Section: Searchmentioning

confidence: 99%

“…4,11,12,26 Different functional outcome measure tools were used: Shih et al 26 used the Foot and Ankle Outcome Score (FAOS), Bilgetekin et al 4 and Herrera-Pérez et al 11 used the American Orthopaedic Foot & Ankle Society (AOFAS) score), and Huang et al 12 used both the Olerud Molander Score (OMS) and the AOFAS score. The follow-up time at which the AOFAS score had been measured was not reported by Bilgetekin et al 4 All other studies reported results on the long term (ie, after 6 months), Herrera-Pérez et al 11 was the only study that reported both short-term (ie, less than 6 months) and longterm scores (Table 2). Huang et al 12 compared and analyzed functional outcome scores for 3 groups (nonlocking, nonanatomical locking, and anatomical locking).…”

Section: Functional Outcomementioning

confidence: 99%

“…13 In the last decade, the increasing amount of literature on the use of locking plates in ankle fracture surgery suggests an increasing use of this type of plate osteosynthesis in daily practice. 1,2,4,7,8,11,12,17,20,21,23,25,26,28 Plate osteosynthesis can be carried out using conventional nonlocking plates, such as one-third tubular plates or dynamic compression plates, but plate osteosynthesis can also be carried out with a variety of later developed locking plates, such as locking compression plates or anatomical locking compression plates. Locking plates allow the opportunity to combine dynamic compression principles with internal fixation using locking screws.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background: The exact benefit of locking plates over nonlocking plates in patients with lateral malleolus fractures remains unclear. The primary aim of this study was to compare the functional outcome of locking plates vs nonlocking plates in patients with a lateral malleolus fracture. The secondary aims were to compare the number of complications and hardware removals and to compare whether results differed for older patients and for patients treated with anatomical locking plates. Methods: The PubMed/MEDLINE, Embase, Cochrane, and CINAHL databases were searched for studies comparing locking plates with nonlocking plates in patients with fixated lateral malleolus fractures. All included studies were assessed on their methodologic quality using the MINORS. Subgroup analyses were performed on older patients and patients treated with anatomical locking plates. Results: A total of 11 studies were included. The meta-analysis showed that functional outcome did not differ between patients treated with locking plates and nonlocking plates (MD 2.38, 95% CI −2.71 to 7.46). No difference in both complication rate (OR 1.10, 95% CI 0.74-1.63) and the amount of hardware removals (OR 0.77, 95% CI 0.52-1.14) was found. Even after analyzing older patients and patients treated with anatomical locking plates, no benefit was shown. Conclusion: This meta-analysis demonstrates no clear benefit in selecting locking plates over nonlocking plates in the treatment of lateral malleolus fractures. Clinical Relevance: Locking plates are increasingly being used in the treatment of lateral malleolus fractures. Biomechanical studies have shown an increased stability with use of locking vs nonlocking plates. This clinical review does not support a benefit of use of locking plates for these fractures.

show abstract

Section: Searchmentioning

confidence: 99%

“…4,7,8,11,12,17,20,21,25,26,28 Ten of the included studies were retrospective cohort studies. 4,7,8,11,12,17,20,21,25,26 One of the included studies was a randomized controlled trial. 28…”

Section: Searchmentioning

confidence: 99%

Section: Functional Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…For patients whose growth plates are not closed yet, threaded screws pose a risk of injury to the growth plate [11]. Furthermore, the commonly used distal bula anatomical locking compression plate (LCP), which is relatively large and must be positioned relatively superior according to the instruction manual, is also not appropriate for these fractures because sometimes the screws are not su cient to secure the distal bular fragment [12]. Therefore, su cient internal xation options with which to treat avulsion fractures of the tip of the lateral malleolus are lacking.…”

Section: Introductionmentioning

confidence: 99%

Locking Compression Plate Distal Ulna Hook Plates as Alternative Fixation for Avulsion Fractures of the Tip of the Lateral Malleolus

Shui

Luo

Yang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Because of the fragment size and inferior location of the fracture lines, options are lacking for internal fixation to treat avulsion fractures of the tip of the lateral malleolus. Because the anatomical architecture of the distal malleolus is similar to that of the distal ulna metaphysis, the purpose of this study was to assess the effectiveness of 2.0-mm locking compression plate distal ulna hook plates in treating avulsion fractures of the tip of the lateral malleolus.Methods: Given the characteristics of the 2.0-mm locking compression plate distal ulna hook plate, cases in which the distance between the fracture lines and the distal end of the tip of the lateral malleolus was less than 6 mm were excluded. Seventeen patients (AO Foundation/Orthopaedic Trauma Association (AO/OTA) 44A fractures, 13 males, 4 females, median age 41 years range 18-73 years) with avulsion fractures of the tip of the lateral malleolus were included. All patients were treated with fixation of the fragment to the fibula using a 2.0-mm locking compression plate distal ulna hook plate. Clinical and radiological follow-up visits were conducted at 6 weeks and 3, 6, 12 and 24 months after the operation. Results: The mean American Orthopedic Foot and Ankle Society Ankle-Hindfoot score of the patients was 97.06±1.92 (range 94 to 100) at the 12-month postoperative follow-up and 97.71±1.54 (range 96 to 100) at the 24-month postoperative follow-up. The mean Karlsson score was 94.18±3.88 (range 90 to 100) at the 12-month postoperative follow-up and 96.43±2.34 (range 95 to 100) at the 24-month postoperative follow-up. Nonunion was not noted; 6 patients complained of lateral malleolar discomfort and foreign body sensation, and 3 of these patients underwent a hardware removal operation at 12 months postoperatively. All patients were clinically and radiographically stable.Conclusion: A 2.0-mm locking compression plate distal ulna hook plate achieved stable and anatomically suitable fixation and should be considered as an alternative treatment for avulsion fractures of the tip of the lateral malleolus.

show abstract

Minifragment plating of the fibula in unstable ankle fractures

Penning

Jonker

Buijsman

et al. 2022

Arch Orthop Trauma Surg

View full text Add to dashboard Cite

Introduction Only 6.4–17% of the load is transmitted through the fibula when weight-bearing. Plate fixation of distal fibular fractures using minifragments (≤ 2.8 mm) could lead to similar reduction with less implant removal (IR) rates, compared to small-fragment plates (3.5 mm). We hypothesized that the use of minifragment plates is at least similar in unscheduled secondary surgery. Materials and methods In this retrospective cohort study, all patients with surgically treated distal fibular fractures between October 2015 and March 2021 were included. Patients treated with plate fixation using minifragments and patients treated with small-fragment plates were compared regarding the following outcomes: secondary dislocation, malreduction, implant malposition, nonunion, surgical site infections (SSI) and IR. Results Sixty-five patients (54.2%) received a minifragment implant (≤ 2.8 mm) and 55 patients (45.8%) received a small-fragment implant (3.5 mm). There were no patients needing secondary surgery in the minifragment group compared to 9 patients following fixation using small-fragment implants (3 with secondary dislocation, 5 with malreduction and 1 with malposition, p = 0.001). SSI rates were 3.1% for minifragment and 9.1% for small-fragment implants (p = 0.161). Implant removal was performed significantly less often following use of minifragment implants (17.8% and 53.2%, p < 0.001). Conclusions In this cohort, minifragment plate fixation for distal fibular fractures is an adequate fixation method offering stable fixation with significant lower need for implant removal and comparable complications to small-fragment plates, although an adequately powered randomized controlled study is needed for implementation in a clinical setting. Level of evidence Therapeutic, III.

show abstract

Comparison of different locking plate fixation methods in lateral malleolus fractures

Cited by 18 publications

References 27 publications

Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis

Operative Fixation of Lateral Malleolus Fractures With Locking Plates vs Nonlocking Plates: A Systematic Review and Meta-analysis

Locking Compression Plate Distal Ulna Hook Plates as Alternative Fixation for Avulsion Fractures of the Tip of the Lateral Malleolus

Minifragment plating of the fibula in unstable ankle fractures

Contact Info

Product

Resources

About