The role of external fixation in acute ankle trauma

Rammelt, Stefan; Endres, Thomas; Grass, R.; Zwipp, H.

doi:10.1016/j.fcl.2004.05.001

Cited by 75 publications

(37 citation statements)

References 46 publications

(88 reference statements)

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“…External fixators used in compound fractures have been associated with a high rate of complications such as pin tract infection, loss of reduction, nonunion and malunion. 8,9 Intramedullary fixation with nails have the advantage of providing a closed stabilization without disturbing the fracture haematoma and also prevents damage to the underlying soft tissues. 15 However due to the fact that the medullary cavity widens at the region of the metaphysis the interlocking nail does not seem to provide the angular and rotational stability required and results in complications like loss of fracture reduction and failure of the implant.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][7] In compound fractures various types of external fixators can be applied but these fixators have a poor patient compliance and also associated with issues such as pintract infection, nonunion and malunion. 8,9 Interlocking intramedullary nailing has been described as a good option for treating distal tibial fractures as advocated by a few authors in their studies. But it is generally considered unsuitable due to technical difficulties and design limitations.…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

et al. 2017

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Background: Management of fractures of the distal tibia remains a challenging proposition due to the fact that the major part of the bone is in a subcutaneous location and the blood supply is quite precarious. Conventional forms of osteosynthesis are associated with high rates of infection and nonunion. Due to extensive soft tissue stripping, the vascularity is compromised and often results in poor wound healing and tends to compromise fracture healing as well. Closed reduction with minimally invasive plate osteosynthesis (MIPO) addresses these issues and has emerged as a viable treatment option with minimal complications. The aim of this study was to assess the functional outcome MIPO using locking compression plates (LCP).Methods: 32 patients with distal tibial fractures treated by MIPO technique with LCP fixation were studied from January 2012 to January 2014 and were followed up for a period of 2 years.Results: All the fractures in our series united well at the end of 6 months with mean time to radiological evidence of callus formation at 10 weeks and the mean time to fracture union was 20 weeks. There were 2 cases with varus angulation in our series and no cases with implant failure. There were 3 patients with superficial skin infections and no cases of deep infection.Conclusions: We conclude that MIPO with LCP is an effective treatment option for distal tibial fractures avoiding all the complications associated with other forms of internal fixation. We strongly recommend its usage in these types of complex injuries.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

et al. 2017

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“…Wound debridement, antibiotics, skin grafting, myocutaneous flap and even arthrodesis have a role to play in management [54] . Studies using external fixation techniques reported significant reduction in infection rates [53,60,61] . The rate of infection is drastically decreased with the use of minimmaly invasive percutaneous plate osteosynthesis (MIPPO) in comparison with external fixator and ORIF [53,62] .…”

Section: Discussionmentioning

confidence: 99%

“…Angular malalignment and malunion have been reported with intramedullary nailing of these fractures [63] . The studies on external fixator showed complications such as imperfect reduction loosening, malunion and pin tract infections [60,61] . Open reduction with fixation of plates have reduced rates angular malunion when compared to external fixation [61] or intramedullary nailing but disadvantages of high incidences of infection.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of distal tibia fracture by mippo using locking compression plate

Chandar¹,

Harish²,

R³

et al. 2017

Int. J. Orthop. Sci.

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Introduction:The following study was conducted to examine the short term clinical and radiological results particularly early complications and healing rate of distal tibia fracture treated by MIPPO using LCP. Methodology: The study was conducted in patients treated for distal tibia fracture (type A, B & C -AO classification) at Adichunchanagiri Institute of Medical Science, BG Nagar from the month of Nov 2013 to Nov 2015. Twenty distal tibia fracture patients were taken into the study, all were fixed with LCP by mippo, some with Bone grafting where the distal tibia fractures were associated with bone loss and communition. Patients' age ranged from 27 to 68 years with a mean of 50. Results: The sample consisted of twenty patients with 11 males and 09 were female. The patients' ages ranged from 27-68 years with a mean age of 50 years. The causes of fractures were motorvehicle accident in 13 patients and fall in 07 patients. There were no sports or industrial accidents. 12 fractures involved the right side and 08 involved the left. The average length of hospitalisation was 15 days with a range of 10 to 20 days. The average number of days from injury to surgery was 5 days with a range of 2 to 10 days. The operative time ranged from 45 minutes to 120 minutes. Patients were followed up from 01 to 24 months. Functional outcome was rated as per The modified ankle score of Olerud and Molander, we got excellent results in 10 cases, good in 07, fair in 02 and poor in one patient. Conclusion:The LCP is a good implant to use for fractures of the distal tibia by mippo method. However, accurate positioning and fixation are required to produce satisfactory results. We recommend use of this implant in Type A, B and C, osteoporotic fractures. Our early results were encouraging but long term studies are needed to prove definitively acceptable outcomes so that the technique can become part of the armamentarium of the orthopaedic trauma surgeon.

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“…External fixation and intramedullary nailing techniques, beyond doubt minimize soft tissue trauma and have been shown to diminish infection but their use is complicated by mal-union, non-union, unsatisfactory reduction of articular surface, and pin tract infection [2][3][4][5][6][13][14][15] . Traditional dynamic plates achieve the first-stage healing of fractures through absolute stable fixation [7] .…”

Section: -6mentioning

confidence: 99%

Minimally invasive percutaneous plate osteosynthesis (MIPPO) in distal tibia fractures-retrospective functional and radiological outcome analysis among rural population

J¹,

Js²,

Manohar³

et al. 2018

Int. J. Orthop. Sci.

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Background: Distal tibia fractures are one of the common fractures and results from indirect coronal or direct axial compression forces. These fractures encompass many and varied fracture configurations that involve medial, lateral, or both sides with many degrees of articular depressions and displacements. Each fracture type has its own characteristic morphology and response to the treatment. Need for Study: Despite many advances in the care of these fractures, distal tibia fractures continue to be a difficult surgical problem. A survey of literatures indicates that many authors report nearly 50% satisfactory results with either closed or operative methods of treatment. In view of these considerations present study was taken up. Aim of Study: The aim of our study was to retrospectively analyze the result of distal tibia fractures managed with LCP plating, the effect on ankle joint function, fracture union, operative difficulties encountered and the incidence of complications in the study population.

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The role of external fixation in acute ankle trauma

Cited by 75 publications

References 46 publications

An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

An evaluation of functional outcome following minimally invasive plate osteosynthesis in fractures of the distal tibia

Surgical management of distal tibia fracture by mippo using locking compression plate

Minimally invasive percutaneous plate osteosynthesis (MIPPO) in distal tibia fractures-retrospective functional and radiological outcome analysis among rural population

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