Intramedullary fixation versus anatomically contoured plating of unstable ankle fractures: a randomized control trial

D, Badenhorst; Terblanche, Ips; Ferreria, N; Burger, Marilize

doi:10.1007/s00264-020-04482-4

Cited by 17 publications

(15 citation statements)

References 19 publications

(34 reference statements)

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“…In particular, the 3 randomized controlled trials available comparing the treatment of unstable ankle fractures with a fibula nail versus plate have demonstrated similar functional results with lower complication rates and less need for implant removal. 7,8,25 Much of the existing literature examined earlier nail designs without dedicated formal proximal fixation which resulted in poorer rotational and axial stability. This led to nail migration and malunion.…”

Section: Discussionmentioning

confidence: 99%

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fleites

Hodgkins

2022

Journal of Orthopaedic Trauma

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Objectives:To evaluate the treatment of unstable lateral malleolar fractures using a fibula nail with both proximal and distal locking capabilities.Design:Retrospective review of 110 single-surgeon consecutive fibula nails.Setting:Single-surgeon, private practice community hospital.Patients/Participants:One hundred ten fractures, 92 OTA/AO 44B and 18 OTA/AO 44C.Intervention:FibuLock fibula nail (Arthrex, Naples, FL).Main Outcome Measurements:Demographic, operative, clinical, and radiographic outcome data.Results:One hundred two patients/102 fractures met criteria. Ninety percent had a f/u of ≥12 months (mean 12.2 months). All fractures healed. There were no superficial or deep infections, no nonunions, or malunions. Two fractures required conversion to plate fixation intraoperatively because of excessive comminution which precluded the use of a nail, while one patient sustained an iatrogenic superficial peroneal nerve neuroma. No patients reported implant irritation, and none have required implant removal.Conclusion:Fibula nails with proximal locking capabilities offer an alternative to plating with the potential for lower complication rates and lower need for implant removal.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Section: Discussionmentioning

confidence: 99%

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fleites

Hodgkins

2022

Journal of Orthopaedic Trauma

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“…Two hundred and ninety-four patients were male (56%, range 37-86%, n = 528). Two papers reported the HIV status of patients (17% positive, 68% negative, 15% unknown, n = 110) [19,20].…”

Section: Demographics Of Patients and Injuriesmentioning

confidence: 99%

Clinical outcomes of ankle fractures in sub-Saharan Africa: a systematic review

Davies

Pennington

Dhadwal³

et al. 2022

Eur J Orthop Surg Traumatol

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Purpose Ankle fractures may cause disability and socioeconomic challenges, even when managed in a high-resource setting. The outcomes of ankle fractures in sub-Saharan Africa are not widely reported. We present a systematic review of the patient-reported outcomes and complications of patients treated for ankle fractures in sub-Saharan Africa. Methods Medline, Embase, Google Scholar and the Cochrane Central Register of Controlled Trials were searched, utilising MeSH headings and Boolean search strategies. Ten papers were included. Data included patient demographics, surgical and non-surgical management, patient-reported outcome measures and evidence of complications. Results A total of 555 patients with ankle fractures were included, 471 of whom were followed up (range 6 weeks–73 months). A heterogenous mix of low-quality observational studies and two methodologically poor-quality randomised trials demonstrated mixed outcomes. A preference for surgical management was found within the published studies with 87% of closed fractures being treated operatively. A total of five different outcome scoring systems were used. Most studies included in this review were published by well-resourced organisations and as such are not representative of the actual clinical practice taking place. Conclusion The literature surrounding the clinical outcomes of ankle fractures in sub-Saharan Africa is sparse. There appears to be a preference for surgical fixation in the published literature and considering the limitations in surgical resources across sub-Saharan Africa this may not be representative of real-life care in the region.

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“…We found no differences in the range of motion between the intervention and control groups overall and between the ankle and tibial plateau fracture subgroups, our results are in line with other studies that reported the range of motion of the ankle and knee. [32][33][34][35][36] Our findings should be interpreted within the limitations of this study. The main limitation was the significant proportion of patients who dropped out.…”

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Anti-gravity treadmill rehabilitation improves gait and muscle atrophy in patients with surgically treated ankle and tibial plateau fractures after one year: A randomised clinical trial

Palke¹,

Schneider

Karich

et al. 2021

Clin Rehabil

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Objective: To compare the one-year postoperative outcomes of anti-gravity treadmill rehabilitation with those of standard rehabilitation in patients with ankle or tibial plateau fractures. Design: An open-label prospective randomised study. Setting: Three trauma centres. Subjects: Patients were randomised into the intervention (anti-gravity treadmill) or control (standard protocol) rehabilitation group. Main measures: The primary endpoint was changes in the Foot and Ankle Outcome Score for ankle fractures and Knee Injury and Osteoarthritis Outcome Score for tibial plateau fractures from baseline to 12 months after operation. Secondary endpoints were the subscores of these scores, muscle atrophy (leg circumference at 20 cm above and 10 cm below the knee joint) and the Dynamic Gait Index. Results: Initially, 73 patients (37 vs 36) underwent randomisation. After 12 months, 29 patients in the intervention group and 24 patients in the control group could be analysed. No significant difference was noted in the Foot and Ankle Outcome Score (80.8 ± 18.4 and 78.4 ± 21.1) and Knee Injury and Osteoarthritis Outcome Score (84.8 ± 15.2 and 81.7 ± 17.0). The change in the Dynamic Gait Index from 12 weeks to 12 months differed significantly between the groups ( P = 0.04). Patients with tibial plateau fractures had a 3 cm wider thigh circumference in the intervention group than those in the control group (95% confidence interval: −0.2 to 6.3 cm, P = 0.08). Conclusion: One year after surgery, patients who had undergone anti-gravity treadmill rehabilitation showed better gait than patients in the control group, and those with tibial plateau fractures had less muscle atrophy.

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Intramedullary fixation versus anatomically contoured plating of unstable ankle fractures: a randomized control trial

Cited by 17 publications

References 19 publications

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Fibula Nailing: A Retrospective Review of 110 Consecutive FibuLock Nails

Clinical outcomes of ankle fractures in sub-Saharan Africa: a systematic review

Anti-gravity treadmill rehabilitation improves gait and muscle atrophy in patients with surgically treated ankle and tibial plateau fractures after one year: A randomised clinical trial

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