Intramedullary Screw Fixation Versus Traditional Plating for Distal Fibula Fractures

McClure, Tanner T; Taylor, Benjamin C.; Huber, Grant; Glazier, Matthew; Myers, Devon; DeGenova, Daniel T

doi:10.1053/j.jfas.2022.09.003

Cited by 2 publications

(1 citation statement)

References 25 publications

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“…26,27 To increase stability of the osteosynthesis, various treatment options are available, such as the combination of two non-locking plates 28 (posterior and lateral), the "K-Wire-Cage" technique 29 or the "Tibia-Pro-Fibula" concept. 30 In older patients with poor soft tissue conditions, it is recommended to consider less invasive techniques with small skin incisions, such as intramedullary fixation like retrograde percutaneous cannulated screw fixation 31 of malleolus as well as intramedullary implants like fibular nails 32 or Illuminoss. 33 Primary nail arthrodesis with a hindfoot nail can provide favorable outcomes in cases of severely compromised soft tissue and in patients with lower functional demands, allowing for early weight-bearing mobilization.…”

Section: Surgical Strategiesmentioning

confidence: 99%

Complications following surgical treatment of ankle fractures in the elderly: can they be avoided?

Welzel,

Omar,

Müller

2024

Orthopedic Reviews

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Background Following surgical treatment of ankle fractures, geriatric patients face high complication rates (CR) in literature. Commonly used diagnostic and treatment algorithms fail to consider requirements of ageing patients which increases the risk of postoperative complications. Objective Present study critically evaluated surgical management of ankle fractures in patients over 65 years old, with focus on identifying modifiable risk factors and effective comorbidity management strategies. Methods We conducted a retrospective single-center study on patients who underwent surgical treatment of an ankle fracture. Based on their age, participants were divided into non-geriatric patients (NGP<65y) and geriatric patients (GP≥65y). We analyzed overall CR and number of minor and major complications in relation to timing of surgery, biological sex, injury pattern, osteosynthesis, pre-existing medical conditions, and postoperative care. Results 402 patients were included. GP encountered significantly higher overall (p<0.001), minor (p<0.001) and major (p=0.003) complications. They presented more complex, displaced and open fractures. Predominant factor contributing to higher CR in NGP and markedly in GP was concomitant diseases, presenting a strong OR of 19,290 (p<0.001) and 17,022 (p<0.001). Delaying surgery and managing comorbidities preoperatively had a favorable impact. Conclusion We revealed a high significant correlation between pre-existing medical conditions and postoperative results. To ascertain viability of delayed surgery in facilitating additional diagnostics and treatment of comorbidities, further comparative trials with a larger cohort are imperative.

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