The diagnosis and treatment of isolated type B fibular fractures: Results of a nationwide survey

Leeuwen, C.A.T. van; Hoffman, Ryan; Donken, C.C.M.A.; Plaat, Laurens W. van der; Schepers, Tim; Hoogendoorn, J. M.

doi:10.1016/j.injury.2018.12.038

Cited by 16 publications

(11 citation statements)

References 36 publications

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“…Ankle fractures are classified according to Danis-Weber type A, B, or C for the lateral malleolus [55,56] and AO 43 for the distal tibia and fibula [57]. Non-operative treatment with a cast is only considered to be an option in cases of stable and non-displaced fractures, including isolated medial malleolar or isolated fibular fractures without syndesmotic rupture or instability [58][59][60]. Open reduction and internal fixation is required in all other more severe cases, in order to obtain a mechanically stable situation and restore the joint's functionality.…”

Section: Ankle Fracturesmentioning

confidence: 99%

Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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Purpose of Review Fractures of osteoporotic bone in elderly individuals need special attention. This manuscript reviews the current strategies to provide sufficient fracture fixation stability with a particular focus on fractures that frequently occur in elderly individuals with osteoporosis and require full load-bearing capacity, i.e., pelvis, hip, ankle, and peri-implant fractures. Recent Findings Elderly individuals benefit immensely from immediate mobilization after fracture and thus require stable fracture fixation that allows immediate post-operative weight-bearing. However, osteoporotic bone has decreased holding capacity for metallic implants and is thus associated with a considerable fracture fixation failure rate both short term and long term. Modern implant technologies with dedicated modifications provide sufficient mechanical stability to allow immediate weight-bearing for elderly individuals. Depending on fracture location and fracture severity, various options are available to reinforce or augment standard fracture fixation systems. Summary Correct application of the basic principles of fracture fixation and the use of modern implant technologies enables mechanically stable fracture fixation that allows early weight-bearing and results in timely fracture healing even in patients with osteoporosis.

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Section: Ankle Fracturesmentioning

confidence: 99%

Biomechanics of Osteoporotic Fracture Fixation

Hollensteiner

Sandriesser

Bliven

et al. 2019

Curr Osteoporos Rep

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“…Although only the isolated Weber B fractures without unstable syndesmotic injuries were included in this study, about half of Weber B malleolar fractures are reportedly combined with distal tibiofibular syndesmosis injuries [16][17][18]. After the fracture fixation, syndesmotic instability was routinely evaluated intraoperatively through the fluoroscopic lateral stress test in our institution.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Anatomically Pre-Contoured Locking Plate for Isolated Weber B Type Fracture

Kim

Chun

Won

et al. 2021

JCM

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We aimed to evaluate the functional and radiographic outcomes of a three-dimensionally (3D) pre-contoured lateral locking plate fixation for isolated Weber B type fractures and to evaluate the necessity of an interfragmentary lag screw in the use of the plate. Patients who underwent surgery for isolated Weber B type fracture were divided into two groups: 41 patients treated with the 3D plate and lag screw (Group A) and 31 patients treated with the 3D plate only (Group B). The included patients were evaluated regarding the functional and radiographic outcomes. According to the McLennan and Ungersma criteria, the majority of patients showed good or fair outcomes in both groups. Comparing the two groups, Group B showed better functional outcomes (p < 0.0046), while no difference between the two groups was found in terms of the radiographic outcomes (p = 0.143). The operation time was significantly shorter in Group B (p < 0.001) and the time to bony union was within 14 months in all patients with no significant difference between the two groups (p = 0.0821). No postoperative complication was observed in both groups. In conclusion, the use of a 3D pre-contoured lateral locking plate fixation for isolated Weber B type fractures demonstrated satisfactory functional and radiographic outcomes, regardless of lag screw insertion.

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“…The average participation rate in studies investigating surgeon preferences for ankle injuries since 2008 is approximately 28%. [ 8 - 17 ] More participants were reached than the average[ 8 - 17 ] although the participation rate seems low. In addition, there was participation from a wide range of experience from residents to faculty members.…”

Section: Discussionmentioning

confidence: 99%

“…Controversial issues were compared with these surveys from other countries. [ 8 - 17 ] The debatable topics on the diagnosis, treatment, and follow-up of ankle fractures accompanied by a syndesmotic injury were determined and a questionnaire was prepared. The survey consisted of 16 questions in four sections: surgeon characteristics (4 questions), syndesmotic injury diagnosis strategy (2 questions), treatment strategy (7 questions), and postoperative follow-up (3 questions) (Table I).…”

Section: Methodsmentioning

confidence: 99%