Osteoporotic Distal Fibula Fractures in the Elderly: How To Fix Them

Sain, Arnab; Garg, Sitender; Vp, Sharma; Meena, Umesh Kumar; Bansal, Hemant

doi:10.7759/cureus.6552

Cited by 4 publications

(4 citation statements)

References 39 publications

(59 reference statements)

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“…The collapse of the distal tibial articular surface in pilon fractures is caused by axial force, and intra-articular damage is severe in patients with osteoporosis ( 69 ). The four classical principles of pilon fractures treatment are as follows: restoration of fibular length, reconstruction of tibial articular surface, autologous bone grafting, and application of buttress plates ( 70 ).…”

Section: Bone Augmentation Strategies For Common Osteoporotic Fracturesmentioning

confidence: 99%

Expert consensus on the bone repair strategy for osteoporotic fractures in China

Zhang

Yan²,

Chen³

et al. 2022

Front. Endocrinol.

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Osteoporotic fractures, also known as fragility fractures, are prevalent in the elderly and bring tremendous social burdens. Poor bone quality, weak repair capacity, instability, and high failure rate of internal fixation are main characteristics of osteoporotic fractures. Osteoporotic bone defects are common and need to be repaired by appropriate materials. Proximal humerus, distal radius, tibia plateau, calcaneus, and spine are common osteoporotic fractures with bone defect. Here, the consensus from the Osteoporosis Group of Chinese Orthopaedic Association concentrates on the epidemiology, characters, and management strategies of common osteoporotic fractures with bone defect to standardize clinical practice in bone repair of osteoporotic fractures.

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Section: Bone Augmentation Strategies For Common Osteoporotic Fracturesmentioning

confidence: 99%

Expert consensus on the bone repair strategy for osteoporotic fractures in China

Zhang

Yan²,

Chen³

et al. 2022

Front. Endocrinol.

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“…Previous studies revealed not only fewer complications of INs compared to standard plate osteosynthesis but also an equal functional outcome ( 37 , 38 ). Intramedullary nailing bears the advantage of immediate full weightbearing and provides the same biomechanical stability compared to a lag screw in combination with a locking plate ( 39 , 40 ). A systematic review with 627 patients treated with a locked IN stated a consolidation rate of 98% with an infection rate of 1% and skin necrosis in 0.6% ( 41 ).…”

Section: Treatment Optionsmentioning

confidence: 99%

Ankle fractures in the elderly: Do we have new concepts?

2023

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The relevance of geriatric ankle fractures is continuously increasing. Treatment of these patients remains challenging and requires adapted diagnostic and therapeutic strategies, as compliance to partial weight bearing is difficult to maintain compared to younger patients. In addition, in the elderly even low impact injuries may lead to severe soft tissue trauma, influencing timing and operative strategies. Recently, the direct posterolateral approach and plate fixation techniques, angular stable implants as well as intramedullary nailing of the distal fibula have been found to improve stategical concepts. This article aims to provide a comprehensive overview of the diagnostic and recent aspects with respect to how this difficult entity of injuries should be approached.

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“…Closed reduction and nail fixation (CRNF) is an alternative minimally invasive treatment option for ankle fractures [ 13 , 14 , 15 , 16 , 17 ]. Less frequent complication rates [ 18 , 19 , 20 , 21 ] and the immediate possibility of full weightbearing postoperatively [ 18 , 22 ] seem to be the advantages of CRNF.…”

Section: Introductionmentioning

confidence: 99%

Fibula Nail versus Locking Plate Fixation—A Biomechanical Study

Kohler

Schenk

Nies

et al. 2023

JCM

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In the treatment of ankle fractures, complications such as wound healing problems following open reduction and internal fixation are a major problem. An innovative alternative to this procedure offers a more minimally invasive nail stabilization. The purpose of this biomechanical study was to clarify whether this method was biomechanically comparable to the established method. First, the stability (range of motion, diastasis) and rotational stiffness of the native upper ankle were evaluated in eight pairs of native geriatric specimens. Subsequently, an unstable ankle fracture was created and fixed with a locking plate or a nail in a pairwise manner. The ankles showed significantly less stability and rotational stiffness properties after nail and plate fixations than the corresponding native ankles (p < 0.001 for all parameters). When comparing the two methods, both showed no differences in their range of motion (p = 0.694) and diastasis (p = 0.166). The nail also presented significantly greater rotational stiffness compared to the plate (p = 0.001). However, both fixations remained behind the native stability and rotational stiffness. Due to the comparable biomechanical properties of the nail and plate fixations, an early weight-bearing following nail fixation should be assessed on a case-by-case basis considering the severity of fractures.

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Osteoporotic Distal Fibula Fractures in the Elderly: How To Fix Them

Cited by 4 publications

References 39 publications

Expert consensus on the bone repair strategy for osteoporotic fractures in China

Expert consensus on the bone repair strategy for osteoporotic fractures in China

Ankle fractures in the elderly: Do we have new concepts?

Fibula Nail versus Locking Plate Fixation—A Biomechanical Study

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