Effectiveness of ankle arthroscopic debridement in acute, subacute ankle- bimalleolar, and trimalleolar fractures

Ceccarini, Paolo; Rinonapoli, Giuseppe; Antinolfi, Pierluigi; Caraffa, Auro

doi:10.1007/s00264-020-04882-6

Cited by 6 publications

(5 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…ARIF for ankle fractures is an acceptable treatment option for ankle fractures involving chondral or osteochondral injuries. However, ARIF for patients with ankle fractures is much debated, and there is no consensus on the optimal treatment for ankle fractures [ 11 ]. Besides, ankle arthroscopy for reducing ankle fractures requires a higher cost and takes longer surgical time.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopically assisted versus open reduction internal fixation for ankle fractures: a systematic review and meta-analysis

Zhang

Chen

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Background Open reduction and internal fixation were routinely used to treat patients with unstable ankle fractures (ORIF). However, some patients may experience persistent ankle pain and disability following ORIF due to untreated intra-articular lesions. Moreover, ankle fractures may be treated with arthroscopically assisted reduction and internal fixation (ARIF). This study aimed to compare the feasibility and benefits of ARIF versus ORIF for ankle fractures. Methods We performed this meta-analysis in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search was conducted for comparative studies comparing ARIF and ORIF for ankle fractures. Nine studies were included in the analysis of clinical and secondary outcomes. In summary, we calculated the mean difference (MD), risk ratio (RR), confidence interval, and p value. Results This meta-analysis demonstrated that the ARIF group achieved a higher Olerud–Molander Ankle (OMA) score (MD: 6.6; 95% CI 0.20 to 13.0; p = 0.04) and lower visual analog scale (VAS) score (MD: − 0.36; 95% CI − 0.64 to − 0.10; p = 0.01) at the final follow-up. Nevertheless, the smallest treatment effect of OMA score and VAS score did not exceed the minimum clinically important difference (MCID). There were longer surgery time (MD: 15.0; 95% CI 10.7 to 19.3; p < 0.01) and lower complication rates (RR: 0.53; 95% CI 0.31 to 0.89; p = 0.02) in ARIF compared with ORIF. The random-effect model suggested no significant difference in the arthritis change rate between the two groups. Conclusion In summary, the results of this meta-analysis indicated that ARIF and ORIF are comparable in terms of providing pain relief and improving function for patients with ankle fractures. Therefore, the choice between the two techniques should be based on the patient's individual factors and the surgeon's personal preference.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopically assisted versus open reduction internal fixation for ankle fractures: a systematic review and meta-analysis

Zhang

Chen

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

show abstract

“…They reported that the PROMIS physical function score and satisfaction rate were statistically higher in those patients who underwent arthroscopy compared with ORIF alone. Ceccarini et al [2] reported the effectiveness of ankle arthroscopic debridement in acute or subacute ankle fractures. They found…”

Section: Discussionmentioning

confidence: 99%

“…Ankle fracture is one of the most common injuries, often accompanied by cartilage lesions and ligament injuries [1]. The standard treatment protocol for unstable ankle fractures is open reduction and internal fixation (ORIF) [2,3]. Despite receiving ORIF and achieving perfect anatomical reduction, some patients still complain residual persistent pains and unsatisfactory functional outcomes [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Arthroscopically assisted internal fixation for treatment of acute ankle fracture: A systematic review and meta-analysis of comparative studies

et al. 2023

View full text Add to dashboard Cite

Background Arthroscopically assisted reduction and internal fixation (ARIF) allows for the assessment of joint congruity following anatomic reduction, identification of occult intra-articular lesions, and treatment of traumatic intra-articular pathologies. The aim of this systematic review and meta-analysis was to provide evidence on whether ARIF is an alternative treatment protocol for ankle fractures. Methods The PubMed, Embase, and Cochrane Library databases were searched independently by two investigators from the inception dates to October 9, 2022, for comparative studies. The risk-of-bias tool of the Cochrane Collaboration for Randomized Controlled Trials and the methodological index for non-randomized studies (MINORS) were used for assessing the methodological quality. Outcomes were evaluated in terms of the Olerud–Molander Ankle Score (OMAS), American Orthopaedic Foot and Ankle Society (AOFAS) Ankle–Hindfoot Scale, post-operative complications, arthroscopic findings, Visual Analogue Scale (VAS) score, and operation time. Cochrane Review Manager Software 5.4 was used to perform the statistical analysis. Results A total of 10 trials involving 755 patients were included in this meta-analysis. The results revealed that ARIF for ankle fractures was superior regarding functional outcomes and VAS scores when compared with open reduction and internal fixation (ORIF). No significant difference was noted in the post-operative complication rate and the operation time between the ARIF and ORIF groups. A high incidence of chondral or osteochondral lesions (OCLs), ligamentous injuries, and loose bodies with ankle fractures was found by ankle arthroscopy. Conclusions ARIF for ankle fractures might be beneficial to offer superior functional outcomes and VAS score than ORIF. Orthopedic surgeons should take a high incidence of OCLs and ligamentous injuries into consideration for the treatment of acute ankle fractures. We believe that with the increase in surgical experience, the occurrence of post-operative complications and the extension of operation time will no longer be a potential concern for surgeons.

show abstract

“…Among the procedures performed before the complete establishment of the sinus approach in our institutions, a dry arthroscope was used to confirm the restoration of the posterior facet articular surface (Figure 9). Different from the usual arthroscopic procedure, mostly used for the ankle, which necessitates saline solution [28,29], an arthroscopic procedure in this case has to be performed in a dry manner for two reasons: first, the presence of a surgical opening, if it is a mini-invasive approach, prevents the creation of an internal pressure; second, an increased peri-calcaneal pressure could create damage to the neighboring anatomical structures in a confined space suffering from a hematoma produced by the fracture. Apart from anatomical reduction of the articular surface, restoration and maintenance of the normal height of the calcaneus are also considered important requisites of successful surgical outcomes, and several studies have shown that restoration of the Bohler's angle leads to better functional outcomes [30,31].…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture

Cho

Kim

Kang

et al. 2021

IJERPH

View full text Add to dashboard Cite

Although various outcomes of the sinus tarsi approach have been reported, these are limited to the Sanders type 2 displaced intraarticular calcaneal fractures (DIACF) because of the limited visibility of the posterior facet joint. In this study we aimed to (1) introduce a sinus tarsi approach combined with an anterolateral fragment open-door technique that enables adequate visibility of the innermost and middle portion of the posterior facet joint, and (2) evaluate the radiographic and clinical outcomes of the patients treated with that technique. This is a retrospective case-series study performed on medical records of 25 patients who presented with the Sanders type 3 or 4 DIACF and were treated with the sinus tarsi approach. The radiologic measurements showed significant corrections of the Bohler’s angle, calcaneal width, length, height, and articular step-off in both X-rays and CTs in the last follow-up period. The mean AOFAS score was 90.08 ± 6.44 at the last follow-up. Among all the follow-up patients, two cases (8%) had acute superficial infections, and no other wound complications occurred. Therefore, we suggest that the Sanders type 3 or 4 DIACF could be successfully treated with the proposed technique with low complications and bring out effective clinical and radiologic outcomes.

show abstract

Effectiveness of ankle arthroscopic debridement in acute, subacute ankle- bimalleolar, and trimalleolar fractures

Cited by 6 publications

References 26 publications

Arthroscopically assisted versus open reduction internal fixation for ankle fractures: a systematic review and meta-analysis

Arthroscopically assisted versus open reduction internal fixation for ankle fractures: a systematic review and meta-analysis

Arthroscopically assisted internal fixation for treatment of acute ankle fracture: A systematic review and meta-analysis of comparative studies

Surgical Treatment Using Sinus Tarsi Approach with Anterolateral Fragment Open-Door Technique in Sanders Type 3 and 4 Displaced Intraarticular Calcaneal Fracture

Contact Info

Product

Resources

About