True antiglide fixation of Danis-Weber B fibula fractures has lower rates of removal of hardware

DeKeyser, Graham J.; Campbell, Megan; Kellam, Patrick; Haller, Justin M.; Rothberg, David L.; Higgins, Thomas F.; Marchand, Lucas S.

doi:10.1016/j.injury.2021.09.051

Cited by 2 publications

(3 citation statements)

References 22 publications

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“…For these reasons, the application of antiglide plates is becoming increasingly popular. Several clinical studies have demonstrated its good outcome and low incidence of peroneal tendonitis with proper application, which Frontiers in Bioengineering and Biotechnology frontiersin.org included avoiding screws in the most distal hole or sinking the screw wholly into the plate (Wenger et al, 2021;DeKeyser et al, 2022). The key to obtaining an antiglide function is to compress over the fracture apex by an undercontoured plate.…”

Section: Plate Fixation Of Lateral Malleolar Fracturesmentioning

confidence: 99%

“…The posterolateral antiglide plate also has the advantages of less skin irritation, fewer wound complications, and a lower reoperation rate ( Winkler et al, 1990 ; Kilian et al, 2017 ; Wenger et al, 2021 ). Moreover, the proper application of low-profile plates does not lead to an increased incidence of peroneal tendonitis ( Weber and Krause, 2005 ; DeKeyser et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

“…The key to the application of the posterolateral antiglide plate in type B lateral malleolar fractures is to compress over the end-tip apex of the distal fragment by an undercontoured plate. However, not all type B lateral malleolar fracture apexes are located on the posterolateral surface of the fibula, which may impair the effect of antiglide mechanisms ( DeKeyser et al, 2022 ). To the best of our knowledge, no previous study has examined the distribution of fracture apexes of type B lateral malleolar fractures or their relationship to the fracture morphology.…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional morphological study of type B lateral malleolar fractures with special reference to the end-tip location of proximal apexes

Wang

Chang

2023

Front. Bioeng. Biotechnol.

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Objective: We aimed to describe the morphological characteristics of Danis–Weber type B lateral malleolar fractures, with special attention given to the end-tip locations of fracture apexes, and to construct a 3D (three-dimensional) fracture line map.Methods: A total of 114 surgically treated cases of type B lateral malleolar fractures were retrospectively reviewed. The baseline data were collected, and computed tomography data were reconstructed in a 3D model. We measured the morphological characteristics and the end-tip location of the fracture apex on the 3D model. All the fracture lines were superimposed on a template fibula to generate a 3D fracture line map.Results: Among these 114 cases, 21 were isolated lateral malleolar fractures, 29 were bimalleolar fractures, and 64 were trimalleolar fractures. All the type B lateral malleolar fractures demonstrated a spiral or oblique fracture line. As measured from the distal tibial articular line, the fracture started at −6.22 ± 4.62 mm anteriorly and terminated at 27.23 ± 12.32 mm posteriorly, and the average fracture height was 33.45 ± 11.89 mm. The fracture line inclination angle was 56.85° ± 9.58°, and the total fracture spiral angle was 269.81° ± 37.09°, with fracture spikes of 156.20° ± 24.04°. The proximal end-tip location of the fracture apex was classified into four zones in the circumferential cortex: zone I (lateral ridge) in seven cases (6.1%), zone II (posterolateral surface) in 65 cases (57%), zone III (posterior ridge) in 39 cases (34.2%), and zone IV (medial surface) in three cases (2.6%). Altogether, 43% (49 cases) of fracture apexes were not distributed on the posterolateral surface of the fibula, as 34.2% (39 cases) were located on the posterior ridge (zone III). The aforementioned morphological parameters in fractures with zone III, sharp spikes, and further broken spikes were greater than those in zone II, blunt spikes, and fractures without further broken spikes. The 3D fracture map suggested that the fracture lines with the zone-III apex were steeper and longer than those with the zone-II apex.Conclusion: Nearly half of type B lateral malleolar fractures had their proximal end-tip of apexes not on the posterolateral surface, which may impair the mechanical application of antiglide plates. A steeper fracture line and longer fracture spike indicate a more posteromedial distribution of the fracture end-tip apex.

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Section: Plate Fixation Of Lateral Malleolar Fracturesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Three-dimensional morphological study of type B lateral malleolar fractures with special reference to the end-tip location of proximal apexes

Wang

Chang

2023

Front. Bioeng. Biotechnol.

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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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True antiglide fixation of Danis-Weber B fibula fractures has lower rates of removal of hardware

Cited by 2 publications

References 22 publications

Three-dimensional morphological study of type B lateral malleolar fractures with special reference to the end-tip location of proximal apexes

Three-dimensional morphological study of type B lateral malleolar fractures with special reference to the end-tip location of proximal apexes

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

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