Complications following operative treatment of supination-adduction type II (AO/OTA 44A2.3) ankle fractures

Carney, John; Ton, Andy; Alluri, Ram K.; Grisdela, Phillip; Marecek, Geoffrey S.

doi:10.1016/j.injury.2020.03.032

Cited by 14 publications

(14 citation statements)

References 34 publications

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“…PROMIS can reliably identify clinical, social, and psychological risk factors for poor outcomes. [25][26][27][28][29][32][33][34][35]. Its weaknesses are lack of specificity for certain body parts, its lack of validation for mental health outcomes, and its ceiling effect in certain active patient populations [23,32,35].…”

Section: Discussionmentioning

confidence: 99%

“…PROMIS has also provided valuable insight into outcomes after specific injury patterns [25][26][27][28][29]. Kohring For patients who sustain supination-adduction type ankle fractures, older age was significantly associated with worse PROMIS Physical Function scores; additionally, the direct medial approach to the ankle, compared to the anteromedial and posteromedial approaches, was associated with better PROMIS Pain Interference scores [27].…”

Section: Outcomes For Specific Injury Patternsmentioning

confidence: 99%

“…Gilley et al used PROMIS Pain Interference and Physical Function to argue that operative fixation of ankle fractures reliably helps patients regain a level of function similar to the United States population mean [ 26 ] . For patients who sustain supination-adduction type ankle fractures, older age was significantly associated with worse PROMIS Physical Function scores; additionally, the direct medial approach to the ankle, compared to the anteromedial and posteromedial approaches, was associated with better PROMIS Pain Interference scores [ 27 ].…”

Section: Outcomes For Specific Injury Patternsmentioning

confidence: 99%

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Patient-Reported Outcome Measurement Information System (PROMIS) in Orthopaedic Trauma Research

Sperring

Danford

Saltzman

et al. 2021

SICOT-J

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This review describes the development, advantages and disadvantages, and applications of the Patient-Reported Outcome Measurement Information System (PROMIS) in orthopaedic trauma. PROMIS is a useful tool for quantifying outcomes in orthopedic trauma. It allows measurement of outcomes across multiple domains while minimizing administration time. PROMIS also reliably identifies clinical, social, and psychological risk factors for poor outcomes across a variety of orthopaedic injuries and disease states. However, PROMIS lacks specificity for certain anatomic regions and validation for mental health outcomes. It also is limited by ceiling effects in certain active patient populations. Orthopaedic traumatologists should be familiar with PROMIS, as its use is increasing and it is a valuable tool that can aid in clinical decision making.

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Section: Discussionmentioning

confidence: 99%

Section: Outcomes For Specific Injury Patternsmentioning

confidence: 99%

Section: Outcomes For Specific Injury Patternsmentioning

confidence: 99%

See 1 more Smart Citation

Patient-Reported Outcome Measurement Information System (PROMIS) in Orthopaedic Trauma Research

Sperring

Danford

Saltzman

et al. 2021

SICOT-J

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“…This is higher than previous reports of articular impaction in SAD patterns, which ranges from 42% to 61%. 1,8,16 We used CT scans to quantify maximum coronal and sagittal plane impaction, which perhaps provides a more comprehensive evaluation of the articular injury than previous methods.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of clinically meaningful articular impaction in SAD type II ankle fractures is largely unknown, although one recent series reports that impaction was noted intraoperatively half of the time and operatively addressed in 84% of these patients. 1,8,16 Furthermore, the influence of articular impaction and reduction quality on posttraumatic arthrosis remains understudied in these injuries. In a prior study, we reported that treatment failure was more common in pilon fractures compared with SAD ankle injuries and introduced the importance of anatomic restoration of the articular surface to optimize outcomes in these patients.…”

Section: Introductionmentioning

confidence: 99%

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

et al. 2021

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Background: Supination-adduction (SAD) type II ankle fractures can have medial tibial plafond and talar body impaction. Factors associated with the development of posttraumatic arthritis can be intrinsic to the injury pattern or mitigated by the surgeon. We hypothesize that plafond malreducton and talar body impaction is associated with early posttraumatic arthrosis. Methods: A retrospective cohort of skeletally mature patients with SAD ankle fractures at 2 level 1 academic trauma centers who underwent operative fixation were identified. Patients with a minimum of 1-year follow-up were included. The presence of articular impaction identified on CT scan was recorded and the quality of reduction on final intraoperative radiographs was assessed. The primary outcome was radiographic ankle arthrosis (Kellgren-Lawrence 3 or 4), and postoperative complications were documented. Results: A total of 175 SAD ankle fractures were identified during a 10-year period; 79 patients with 1-year follow-up met inclusion criteria. The majority of injuries resulted from a high-energy mechanism. Articular impaction was present in 73% of injuries, and 23% of all patients had radiographic arthrosis (Kellgren-Lawrence 3 or 4) at final follow-up. Articular malreduction, defined by either a gap or step >2 mm, was significantly associated with development of arthrosis. Early treatment failure, infection, and nonunion was rare in this series. Conclusion: Malreduction of articular impaction in SAD ankle fractures is associated with early posttraumatic arthrosis. Recognition and anatomic restoration with stable fixation of articular impaction appears to mitigate risk of posttraumatic arthrosis. Investigations correlating postoperative and long-term radiographic findings to patient-reported outcomes after operative treatment of SAD ankle fractures are warranted. Level of Evidence: Level IV, retrospective case series.

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Management of Fractures of the Tibial Plafond

Unno,

Nork

2023

Evaluation and Surgical Management of the Ankle

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Complications following operative treatment of supination-adduction type II (AO/OTA 44A2.3) ankle fractures

Cited by 14 publications

References 34 publications

Patient-Reported Outcome Measurement Information System (PROMIS) in Orthopaedic Trauma Research

Patient-Reported Outcome Measurement Information System (PROMIS) in Orthopaedic Trauma Research

Plafond Malreduction and Talar Dome Impaction Accelerates Arthrosis After Supination-Adduction Ankle Fracture

Management of Fractures of the Tibial Plafond

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