Comparison of Lag Screw Versus Buttress Plate Fixation of Posterior Malleolar Fractures

Erdem, Mehmet; Erken, H. Yener; Burç, Halil; Saka, Gürsel; Korkmaz, Medet; Aydoğan, Mehmet

doi:10.1177/1071100714540893

Cited by 73 publications

(69 citation statements)

References 22 publications

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“…Choi reported a mean AOFAS score of 90.6 following ORIF of PMF through a modified posterolateral approach [28]. Erdem achieved a mean AOFAS score of 94.1 of PMF following posterior-to-anterior lag screw fixation or buttress plate fixation through posterolateral approach [30]. Compared with our study, the patients with a PMF smaller than 25% of articular surface were included in these studies, which might contribute to the higher AOFAS scores reported in these studies.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

Xiong

Chen

et al. 2017

BMC Musculoskelet Disord

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BackgroundThe optimal method for the reduction and fixation of posterior malleolar fracture (PMF) remains inconclusive. Currently, both of the indirect and direct reduction techniques are widely used. We aimed to compare the reduction quality and clinical outcome of posterior malleolar fracture managed with the direct reduction technique through posterolateral approach or the indirect reduction technique using ligamentotaxis.MethodsPatients with a PMF involving over 25% of the articular surface were recruited and assigned to the direct reduction (DR) group or the indirect reduction (IR) group. Following reduction and fixation of the fracture, the quality of fracture reduction was evaluated in post-operative CT images. Clinical and radiological follow-ups were performed at 6 weeks, 3 months, 6 months, 12 months, and then at 6 month-intervals postoperatively. Functional outcome (AOFAS score), ankle range of motion, and Visual Analog Scale (VAS) were evaluated at the last follow-up. Statistical differences were compared between the DR and IR groups considering the patient demographics, quality of fracture reduction, AOFAS score, and VAS.ResultsTotally 116 patients were included, wherein 64 cases were assigned to the DR group and 52 cases were assigned to the IR group. The quality of fracture reduction was significant higher in the DR group (P = 0.038). In the patients who completed a minimum of 12 months’ follow-up, a median AOFAS score of 87 was recorded in the DR group, which was significantly higher than that recorded in the IR group (a median score of 80). The ankle range of motion was slightly better in the DR group, with the mean dorsiflexion restriction recorded to be 5.2° and 6.1° in the DR and IR group respectively (P = 0.331). Similar VAS score was observed in the two groups (P = 0.419).ConclusionsThe direct reduction technique through a posterolateral approach provide better quality of fracture reduction and functional outcome in the management of PMF over 25% of articular surface, as compared with the indirect reduction technique using ligamentotaxis.Trial registration NCT02801474 (retrospectively registered, June 2016, ClinicalTrails.gov).

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Section: Discussionmentioning

confidence: 99%

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

Xiong

Chen

et al. 2017

BMC Musculoskelet Disord

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“…The method of posterior malleolar fixation is controversial. Erdem et al compared the clinical and radiographic outcomes of the use of either lag-screw fixation or buttress-plate fixation through a posterolateral approach 10 . After a mean follow-up of 3 years, all fractures achieved union and no difference in AOFAS scores was observed between the treatment groups.…”

Section: Ankle Fractures and Syndesmotic Injuriesmentioning

confidence: 99%

What’s New in Foot and Ankle Surgery

Yeranosian

2016

The Journal of Bone and Joint Surgery

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“…[5,7,13] It is thought that it might reduce development of OA, which would ultimately result in better function. As of yet, however, there is no good scientific evidence of this.…”

Section: Discussionmentioning

confidence: 99%

“…[2,6,10] Based on biomechanical, cadaveric, and small population studies, fragment size is frequently cited as one of the main indications for fixation with thresholds for surgery ranging from 25% to 33% of the anteroposterior (AP) dimension of the articular surface. [2,[10][11][12][13] However, thus far there has not been any strong clinical evidence and no consensus.…”

Section: Introductionmentioning

confidence: 99%

Importance of Fixation of Posterior Malleolus Fracture in Trimalleolar Fractures: A Retrospective Study

Karaca¹,

Enercan

Özdemir³

et al. 2016

Ulus Travma Acil Cerrahi Derg

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Comparison of Lag Screw Versus Buttress Plate Fixation of Posterior Malleolar Fractures

Abstract: Level II, prospective case series.

Cited by 73 publications

References 22 publications

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

Comparison of the direct and indirect reduction techniques during the surgical management of posterior malleolar fractures

What’s New in Foot and Ankle Surgery

Importance of Fixation of Posterior Malleolus Fracture in Trimalleolar Fractures: A Retrospective Study

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