The ANK Nail Treatment of the Lateral Malleolar Fractures With Syndesmosis Injury; Clinical Outcomes at 10 Years Follow up.

Abstract

BACKGROUND: Lateral malleolar fractures associated with syndesmotic injuries are common. Various surgical implants may be used for the management of syndesmosis injury. One of these is ANK nail. The aim of the present study was to assess the clinical and radiological outcomes of patients treated with ANK nail. METHODS:Forty-eight patients who were followed up for a minimum of 10 years were reviewed retrospectively using American Orthopedic Foot and Ankle Society (AOFAS) score, radiological evaluation, and development of posttraumatic arthritis. Final data were collected at the last follow-up. RESULTS:The mean age of the patients was 37.3 (17-69) years. The mean follow-up was 129.9 (123-150) months. Twenty-two patients had Weber type B fracture, and their mean AOFAS score was 93.36 points. The remaining 26 patients had Weber type C fracture, and their mean AOFAS score was 97.66 points. There was no relationship between the type of fracture and the clinical outcome. There was a significant correlation between shortening of the fibula and posttraumatic arthritis. CONCLUSION:The ANK nail used for the management of ankle fractures may provide both fracture and syndesmosis stabilities in selected cases and is also a cost effective method as cheap as a cortical screw and a Kirschner wire.

Use of K-wire for fixation of lateral malleolar fractures, an alternative to plate fixation in a low resource settings

“…2 Our study did not take into consideration a particular technique to take care of syndysmotic tear in Weber type B ankle fracture, many similar studies reported use of different intramedulary devices for lateral fibular fracture in their studies; they made use of ANK (Ayhan Nedim Kara) nail for communited and oblique fractures that had associated syndesmotic ligament tear with great postoperative success. 22,23 Although our study made use of nonlocked 3mm K-wire, the biomechanical strength cannot be compared with both conventional locked nail and plate fixation as reported by other biomechanical studies performed to compare use of IM nail and plates for treatment of both comminuted and non-comminuted fractures of the distal third of fibula. 8,9 However, use of K-wire as an implant for the fixation is quite relevant and justifiable as the fibula is not a full-weight bearing bone, though its distal part is integral to the stability of the ankle joint.…”

Pediatric Ankle Syndesmosis Injuries

“…Weber C fractures are more likely to be associated with injury to the syndesmosis. 10,21 Children with open physes can have Salter-Harris fractures in the fibula and tibia; thus, ankle fracture classification systems such as Dias-Tachdjian have been developed for pediatric populations. [22][23][24] An open physis more often leads to certain fractures found in children and is thought to be a protective factor against syndesmotic injury.…”