Tubular vs Profile Plate in Peroneal or Bimalleolar Fractures: is There a Real Difference in Skin Complication? A Retrospective Study in Three Level I Trauma Center

Petruccelli, Rosario; Bisaccia, Michele; Rinonapoli, Giuseppe; Rollo, Giuseppe; Meccariello, Luigi; Falzarano, Gabriele; Ceccarini, Paolo; Bisaccia, Olga; Giaracuni, Marco; Caraffa, Auro

doi:10.5455/medarh.2017.71.265-269

Cited by 14 publications

(19 citation statements)

References 20 publications

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“…The presented complication rates are consistent with the rates described in the current literature [ 12 , 35 ]. Group II treated by the polyaxial locking plate showed lower postoperative complications, 2 (10%) minor and 1 (5%) major ones in comparison to group I (semitubular plate) presenting 4 minor (16%) and 2 major complications (8%).…”

Section: Discussionsupporting

confidence: 91%

“…Schepers et al do not recommend the treatment of distal fibular fractures with semitubular plates since the authors describe an elevated complication rate of 17.5% [ 15 ]. In contrast Petruccelli et al [ 35 ] published a study presenting only 8.9% ( n = 4) wound complications in distal fibular FX treated with locking compression plates compared to a treatment with semitubular plates with 6.3% ( n = 3) complications without statistical difference between both treatment groups. Similar low infection rates were published by Tsukada et al [ 12 ].…”

Section: Discussionmentioning

confidence: 95%

“…First retrospective clinical studies revealed a benefit of locking plates in osteoporotic patients [ 26 , 33 ] but also persisting high complication rates [ 12 , 13 , 15 ]. Nevertheless locking plate systems are still under economical discussion because of high implant costs [ 13 , 15 , 26 , 34 , 35 ].…”

Section: Introductionmentioning

confidence: 99%

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Is early full weight bearing safe following locking plate ORIF of distal fibula fractures?

Zyskowski

Wurm

Greve

et al. 2021

BMC Musculoskelet Disord

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Background In the modern western world appraisal of economical points such as treatment and disability after trauma present a financial burden. In this context open reduction internal fixation techniques allowing for early full weight bearing might not only improve the clinical outcome but also shorten the period of disability in working life. The aim of the study was to analyze whether ORIF of ankle fractures using either a standard semitubular plate or a new polyaxial locking plate system result in a better clinical outcome. Methods In this prospective study, all patients with distal fibula fractures (AO 44 B1.1, B1.2, B1.3), with indication for surgery were included. Patients were randomized to either the DePuy Synthes® one-third semitubular plate (Group I) or NEWCLIP TECHNICS, Active Ankle® polyaxial locking plate (Group II). Primary outcome parameter was function of the ankle joint, assessed by the Olerud and Molander ankle score, Foot and Ankle outcome score and Karlsson and Peterson Scoring System for Ankle function. Secondary outcome parameter were postoperative complications. Superficial wound infection, delayed wound healing, mechanically prominent implant, skin irritations were considered as minor and deep wound infection, material loosening, loss of reduction were regarded as major complications requiring revision surgery. Clinical and radiological follow-up were performed 6 and 12 weeks, 6 months and 1 year postoperatively. Results Fifty-two patients (31 W/21 M) with a mean age of 43 yrs. (range 22–64 yrs.) were enrolled. Seven patients (13.5%) were excluded, so that 45 patients were available for follow up. Twenty-five patients were treated with DePuy Synthes® one-third semitubular plate (55.6%; group I) while 20 patients received an anatomically preformed polyaxial locking plate (44.4%, group II). Four minor complications occurred in Group I (16%) compared to two minor complications in group II (10%). Significant better clinical results regarding OMAS (p < 0.02, < 0.04), KPSS (p < 0.04) and FAOS (p < 0.02, < 0.03) were observed 6 and 12 weeks after surgery in group II. Conclusions The results of the presented study demonstrate a significant better clinical functional outcome in the early postoperative follow-up in patients treated with a polyaxial locking plate. Furthermore, our data show that ORIF using polyaxial locking plates in combination with an early postoperative weight bearing presents a safe, stable treatment option for ankle fractures so that patients benefit especially in the early stages of recovery. Trial registration Registered 20 April 2020, retrospectively on ClinicalTrails.gov (NCT04370561).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 95%

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Is early full weight bearing safe following locking plate ORIF of distal fibula fractures?

Zyskowski

Wurm

Greve

et al. 2021

BMC Musculoskelet Disord

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show abstract

“…In the context of lower-limb fractures, assessments of feasibility and quality of life, including the reduction of fracture, infection and union complication, soft tissue recovery, and functional outcomes, were commonly evaluated in the literature [ 19 , 20 ]. Various clinical studies have discussed the conventional strategies such as intramedullary nailing, locked plate, and external fixation in terms of the effectiveness in tibial or peroneal factures [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison Between the Modified External Fixation and Calcaneal Traction in Ruedi-Allgower Type II/III Pilon Fractures

Shu

Yang

2021

Med Sci Monit

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Background To compare the effect of modified external fixation and calcaneal traction in a staged management of Ruedi-Allgower type II/III tibial pilon fractures. Material/Methods The data of 62 patients with Ruedi-Allgower type II/III tibial pilon fractures who were treated in Liuzhou People’s hospital from January 2017 to December 2018 were extracted in this retrospective analysis. There were 32 patients in the temporary external fixation (TEF) group and 30 patients in calcaneal traction (CT) group. Outcomes, including the duration of the surgical procedure, pin track infection, degree of limb swelling, time to second-stage operation, postoperative comfort score, and visual analog scale (VAS) score, were compared. Results The effective rate of swelling reduction after treatment was 85% in the TEF group and 60% in the CT group; the average time to the second-stage operation was 8.34±1.29 days in the TEF group and 10.60±2.27 days in the CT group; the postoperative comfort scores were 70.1±3.2 and 61.3±3.5 in the TEF group and CT group, respectively; the postoperative VAS scores at 24 h, 48 h, and 7 days were 7.90±1.06, 4.88±0.83, 2.72±1.14 in TEF group, and 8.50±0.86, 6.27±1.36, 3.57±1.19 in CT group, respectively. There were 1 case of pin tract infection identified in the TEF group and 4 in the CT group. All differences were statistically significant (P<0.05). Conclusions The modified external fixation is more effective than calcaneal traction in treatment of Ruedi-Allgower type II/III tibial pilon fractures in the first-stage of combined management.

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“…Biofilm renders bacteria highly tolerant to antibiotics and host defenses [6][7][8]. Unfortunately, infections of the orthopedic-traumatological surgical site are very common in children [9] and in the elderly [10][11][12][13][14][15][16][17][18][19][20].The aim of our work is to verify if there are differences between pathogens, and treatment between the two groups most susceptible to skin infections by means of synthesis such as children and the elderly.…”

Section: Introductionmentioning

confidence: 99%

Children vs elderly in orthopedic surgery site of infection. Are there difference? Experience of a high volume plastic surgeon consultant.

Franzese¹,

Conte²,

Gagliardo³

et al. 2020

Acta Med Sal

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Introduction: Prevention of surgical site infection in surgery and bone trauma has some hallmarks not shared with other surgical disciplines. The surgeon is not always able to open the pathogen and a key to correct therapy. The aim of our work is to verify if there are differences between pathogens, and treatment between the two groups most susceptible to skin infections by means of synthesis such as children and the elderly. Materials and Methods: From January 2011 to december 2018, we perform 3189 consultancies in various departments of orthopedics and traumatology. From the exclusion criteria we recruited 168 patients with superficial infection of the surgical site after orthopedic surgery. A group represented by children (under 12 years old) and a group of older people over 65. The evaluation criteria between the two groups were: the infectious bacterial flora; the type of antibiotic, the duration of antibiotic therapy; the type of medications used in the post-operative period, the complications.Results:The results showed that elderly patients are more likely to be bacterial superinfection due to poor hygiene. Therapy in children is shorter and has minor complications. Proper management of the surgical site showed a rapid resolution of the infection in both groups. Conclusion: The correct management and hygiene of the surgical site allows its rapid recovery from infection. The plastic surgeon management of the fracture site infection can be a winning weapon in the treatment of this problem both in the child and in the elderly.

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Tubular vs Profile Plate in Peroneal or Bimalleolar Fractures: is There a Real Difference in Skin Complication? A Retrospective Study in Three Level I Trauma Center

Cited by 14 publications

References 20 publications

Is early full weight bearing safe following locking plate ORIF of distal fibula fractures?

Is early full weight bearing safe following locking plate ORIF of distal fibula fractures?

Comparison Between the Modified External Fixation and Calcaneal Traction in Ruedi-Allgower Type II/III Pilon Fractures

Children vs elderly in orthopedic surgery site of infection. Are there difference? Experience of a high volume plastic surgeon consultant.

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