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trimalleolar fracture

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https://www.readbyqxmd.com/read/28371502/comparison-of-posteromedial-versus-posterolateral-approach-for-posterior-malleolus-fixation-in-trimalleolar-ankle-fractures
#1
Sheng Zhong, Lin Shen, Jia-Guo Zhao, Jie Chen, Jin-Feng Xie, Qi Shi, Ying-Hua Wu, Xian-Tie Zeng
OBJECTIVE: To compare clinical and radiographic outcomes of posterior malleolar fractures (PMF) treated with lag screws from anterior to posterior versus posterior to anterior approach. METHODS: We retrospectively analyzed 48 patients with trimalleolar fractures who underwent open reduction and internal fixation (ORIF) with either posteromedial (PM) or posterolateral (PL) approaches between January 2012 and December 2014. Fixation of the posterior malleolus was made with anteroposterior screws in 20 patients using the PM approach and posteroanterior screws in 28 patients using the PL approach...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28074463/importance-of-fixation-of-posterior-malleolus-fracture-in-trimalleolar-fractures-a-retrospective-study
#2
Sinan Karaca, Meriç Enercan, Güzelali Özdemir, Sinan Kahraman, Mutlu Çobanoğlu, Metin Küçükkaya
BACKGROUND: The aim of this retrospective study was to evaluate treatment effect and importance of posterior malleolus (PM) fixation in surgically treated trimalleolar fractures. METHODS: A total of 57 cases of ankle joint fracture involving PM and treated with open reduction and internal fixation technique between 2004 and 2011 were evaluated. PM fixation was performed with cannulated screws in 46 cases, and in 11 cases, PM plate was used. All patients were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, American Academy of Orthopedic Surgeons (AAOS) foot and ankle questionnaire, and Visual Analog Score (VAS) pain scale...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28041950/association-of-body-mass-index-with-the-pattern-of-surgically-treated-ankle-fractures-using-two-different-classification-systems
#3
Knut Stavem, Markus G Naumann, Ulf Sigurdsen, Stein Erik Utvåg
The present retrospective cohort study assessed the association of body mass index (BMI) with the pattern of ankle fractures using 2 classifications systems. Of the 1011 consecutive patients who underwent surgery for ankle fractures in 2 hospitals from January 2009 to December 2011, 837 had a classifiable fracture according to 1 of 2 classification systems and complete information available for covariates. The association of BMI, adjusted for age, sex, corticosteroid use, diabetes, and smoking status with having a more proximal fibula fracture (Weber class A to C) and an increasing number of malleoli involved (uni-, bi-, or trimalleolar) was assessed using multivariable ordered logistic regression analysis...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28041949/comparison-of-early-adverse-events-after-operative-treatment-of-bimalleolar-and-trimalleolar-fractures-versus-pilon-fractures
#4
Karim Z Masrouha, Hani Tamim, Assad Taha, Abdel Majid Sheikh Taha, Racha Abi-Melhem, Muhyeddine Al-Taki
Ankle fractures requiring open reduction and internal fixation vary in severity from unimalleolar fractures to bimalleolar/trimalleolar (BT) fractures to pilon fractures. Consequently, the postoperative outcomes with these surgeries can vary. Most previous studies of these injuries had small sample sizes, studied a single risk factor or adverse event, or did not compare different injuries by severity. The purpose of the present study was to describe and compare the patient characteristics and postoperative outcomes of 2 high-energy ankle fractures: BT and pilon fractures...
March 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28027660/cross-sectional-study-to-assess-the-functional-outcome-of-neglected-bimalleolar-fracture
#5
Rajeev Shukla, Ravi Kant Jain, Shravan Patidar, Nikhil Jain, Pranav Mahajan
INTRODUCTION: Ankle fracture is the most common intra-articular fracture of a weight-bearing joint and accounts for 9% of all fractures. Ankle fractures are classified into 3 subgroups: unimalleolar, bimalleolar, and trimalleolar fractures. Accurate reduction and stable internal fixation is necessary in bimalleolar fractures; otherwise, it may lead to posttraumatic painful restriction of movements or osteoarthritis. The purpose of this study is to assess the functional outcome and results of treatment of neglected bimalleolar fracture...
December 1, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28005114/an-update-on-management-of-syndesmosis-injury-a-national-us-database-study
#6
James C Carr, Brian C Werner, Seth R Yarboro
We conducted a study to determine the incidence of syndesmotic injury and stabilization within various ankle fracture patterns along with the rate of syndesmotic implant removal. All data were obtained from a publicly available for-fee healthcare database, the PearlDiver Patient Records Database. Current Procedural Terminology (CPT) codes were used to search the database for cases of fixation of lateral malleolus, bimalleolar, and trimalleolar fractures in addition to syndesmotic fixation and implant removal...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27992638/medial-malleolar-fractures-and-associated-deltoid-ligament-disruptions-current-management-controversies
#7
REVIEW
Nicholas A Kusnezov, Emmanuel D Eisenstein, Nabih Diab, Ahmed M Thabet, Amr Abdelgawad
Operative fixation of medial malleolar fractures, whether isolated or in the setting of bi- or trimalleolar fractures, remains controversial. Increasingly, anatomic reduction and internal fixation is used to treat medial malleolar fractures to avoid long-term sequelae of symptomatic nonunion and posttraumatic osteoarthritis. However, outcomes have not been significantly different between operative and nonoperative cohorts. Repair of associated deltoid ligament disruption is not common because of reportedly poor outcomes...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27984443/the-role-of-computed-tomography-in-surgical-planning-for-trimalleolar-fracture-a-survey-of-ota-members
#8
Peter D Gibson, Micheal J Bercik, Joseph A Ippolito, Jacob Didesch, John S Hwang, Kenneth L Koury, Michael Sirkin, Mark Adams, Mark C Reilly
OBJECTIVE: Does the additional information provided by computed tomography (CT) alter surgeons' treatment plans for trimalleolar ankle fracture? DESIGN: Prospective. SETTING: Electronic survey. PATIENTS/PARTICIPANTS: Members of the OTA. INTERVENTION: Compare management of trimalleolar ankle fracture before and after CT. MAIN OUTCOME MEASUREMENTS: Compare types of fixation used, indication for fixation, and approach need for fixation before and after CT...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27798067/radiolucent-triangle-as-a-positioning-tool-to-simplify-prone-ankle-fracture-surgery-technical-tip
#9
Kamran S Hamid, Travis J Dekker, Peter W White, Samuel B Adams
Prone positioning affords significant benefits for the fixation of trimalleolar ankle fractures and has been the long-time standard for treatment of these injuries. However, 2 primary disadvantages hamper its utility. First, access to the medial ankle is impeded by the contralateral limb and inability to rotate the operative leg to the extent that is possible in other positions. Second, lateral fluoroscopic imaging of the ankle can be cumbersome and often necessitates physically elevating the ankle for a radiograph then placing it back on the operative table...
October 25, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27762616/surgical-treatment-of-lateral-malleolar-fractures-using-the-compression-cerclage-system
#10
Eren Cansü, Mehmet B Unal, Serkan Gurcan, Fatih Parmaksizoglu
Background Lateral malleolar fractures (Weber type B or OTA 44-B) account for 60% of all ankle fractures. To achieve anatomic restoration, surgical stabilization provides better results than conservative treatment. Various fixation methods are available to treat these fractures; however, the best method is still unknown. Our objectives were to present a new, useful, and efficient surgical technique for stabilizing lateral malleolar fractures and to analyze the outcomes of patients treated with the compression cerclage system...
September 2, 2016: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/27446944/application-of-3d-printing-in-the-surgical-planning-of-trimalleolar-fracture-and-doctor-patient-communication
#11
Long Yang, Xian-Wen Shang, Jian-Nan Fan, Zhi-Xu He, Jian-Ji Wang, Miao Liu, Yong Zhuang, Chuan Ye
To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A) and the no-3D printing assisted-design group (Group B). In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27301739/a-radiological-sign-which-we-are-calling-the-tongues-of-flame-sign-in-irreducible-trimalleolar-fractures-of-the-ankle
#12
Jike Lu, Masumi Maruo Holledge, Jac Trappel, Mehul Mayank
BACKGROUND: The irreducible trimalleolar fracture case we describe is different from the Bosworth fracture, defined as a fixed posterior fracture-dislocation of the distal part of the fibula, in which the proximal fibular shaft fragment locks behind posterior tibial tubercle. This fracture is frequently irreducible by closed means as well. METHODS: We describe a rare case of trimalleolar fracture/dislocation that cannot be reduced by closed means, and review the relevant literature...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27235525/open-reduction-and-internal-fixation-of-posterior-malleolar-fractures-using-the-posterolateral-approach
#13
S M Verhage, F Boot, I B Schipper, J M Hoogendoorn
AIMS: Involvement of the posterior malleolus in fractures of the ankle probably adversely affects the functional outcome and may be associated with the development of post-traumatic osteoarthritis. Anatomical reduction is a predictor of a successful outcome. The purpose of this study was to describe the technique and short-term outcome of patients with trimalleolar fractures, who were treated surgically using a posterolateral approach in our hospital between 2010 and 2014. PATIENTS AND METHODS: The study involved 52 patients...
June 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27082888/locking-versus-nonlocking-implants-in-isolated-lower-extremity-fractures-analysis-of-cost-and-complications
#14
COMPARATIVE STUDY
Thomas J An, Rachel V Thakore, Sarah E Greenberg, Vasanth Sathiyakumar, Harrison F Kay, Michael Gerasimopoulos, William T Obremskey, Manish K Sethi
The purpose of this study was to investigate operative costs and postoperative complication rates in relation to utilization of locking versus nonlocking implants in isolated, lower limb fractures. Seventy-seven patients underwent plate fixation of isolated bicondylar tibial plateau, bimalleolar ankle, and trimalleolar ankle fractures at a large tertiary care center. Fixation with locking versus nonlocking implants was compared to incidence of postsurgical complications. Costs of these implants were directly compared...
2016: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/27044212/-application-of-computer-assisted-surgical-planning-in-surgical-treatment-of-ankle-fractures
#15
Shengli Xia, Xiuhui Wang, Beigang Fu, Yaogang Lu, Minghui Wang
OBJECTIVE: To explore the clinical value of computer-assisted surgical planning in the treatment of ankle fractures. METHODS: Between January 2012 and January 2014, open reduction and internal fixation were performed on 42 patients with ankle fractures. There were 22 males and 20 females with an average age of 52 years (range, 19-72 years). The causes were spraining injury (20 cases), traffic accident injury (14 cases), and falling from height injury (8 cases). The time from injury to operation was 5 hours to 12 days (mean, 2...
December 2015: Chinese Journal of Reparative and Reconstructive Surgery
https://www.readbyqxmd.com/read/26968233/value-of-early-postoperative-computed-tomography-assessment-in%C3%A2-ankle-fractures-defining-joint-congruity-and-criticizing-the-need-for-early-revision-surgery
#16
Ezequiel Palmanovich, Yaron S Brin, Benny Kish, Meir Nyska, Iftach Hetsroni
Previous investigators have questioned the reliability of plain radiographs in assessing the accuracy of ankle fracture reduction when these were compared with the computed tomography (CT) evaluation in the preoperative setting, in particular, in fractures with syndesmosis injuries or trimalleolar fragments. The role of CT assessment, however, has not been investigated in the early postoperative setting. In the early postoperative setting, reduction still relies most commonly on fluoroscopy and plain radiographs alone...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/26802427/early-weightbearing-after-operatively-treated-ankle-fractures-a-biomechanical-analysis
#17
Eric W Tan, Norachart Sirisreetreerux, Adrian G Paez, Brent G Parks, Lew C Schon, Erik A Hasenboehler
BACKGROUND: No consensus exists regarding the timing of weightbearing after surgical fixation of unstable traumatic ankle fractures. We evaluated fracture displacement and timing of displacement with simulated early weightbearing in a cadaveric model. METHODS: Twenty-four fresh-frozen lower extremities were assigned to Group 1, bimalleolar ankle fracture (n=6); Group 2, trimalleolar ankle fracture with unfixed small posterior malleolar fracture (n=9); or Group 3, trimalleolar ankle fracture with fixed large posterior malleolar fracture (n=9) and tested with axial compressive load at 3 Hz from 0 to 1000 N for 250 000 cycles to simulate 5 weeks of full weightbearing...
June 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/26657889/high-incidence-of-osteochondral-lesions-after-open-reduction-and-internal-fixation-of-displaced-ankle-fractures-medium-term-follow-up-of-100-cases
#18
Marc Regier, Jan Philipp Petersen, Ahmet Hamurcu, Eik Vettorazzi, Cyrus Behzadi, Michael Hoffmann, Lars G Großterlinden, Florian Fensky, Till Orla Klatte, Lukas Weiser, Johannes M Rueger, Alexander S Spiro
BACKGROUND: The incidence of osteochondral lesions (OCLs) in association with displaced ankle fractures has only been examined in two previous studies. In both studies magnetic resonance imaging (MRI) was performed prior to open reduction and internal fixation (ORIF). Because MRI may overdiagnose or overestimate the extent of OCLs in an acute trauma setting the aim of this study was to determine the incidence of OCLs after ORIF of displaced ankle fractures using MRI at medium-term follow-up, and to analyse if the severity of fracture or the clinical outcome correlates with the incidence of OCLs...
March 2016: Injury
https://www.readbyqxmd.com/read/26611896/reliability-of-classification-for-post-traumatic-ankle-osteoarthritis
#19
Femke M A P Claessen, Diederik T Meijer, Michel P J van den Bekerom, Barend D J Gevers Deynoot, Wouter H Mallee, Job N Doornberg, C Niek van Dijk
PURPOSE: The purpose of this study was to identify the most reliable classification system for clinical outcome studies to categorize post-traumatic-fracture-osteoarthritis. METHODS: A total of 118 orthopaedic surgeons and residents-gathered in the Ankle Platform Study Collaborative Science of Variation Group-evaluated 128 anteroposterior and lateral radiographs of patients after a bi- or trimalleolar ankle fracture on a Web-based platform in order to rate post-traumatic osteoarthritis according to the classification systems coined by (1) van Dijk, (2) Kellgren, and (3) Takakura...
April 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/26542855/size-matters-the-influence-of-the-posterior-fragment-on-patient-outcomes-in-trimalleolar-ankle-fractures
#20
COMPARATIVE STUDY
Julia Evers, Linda Barz, Dirk Wähnert, Niklas Grüneweller, Michael J Raschke, Sabine Ochman
INTRODUCTION: Ankle fractures are increasing in incidence. The more complicated the lesion is, the higher the risk of developing posttraumatic arthrosis. Severe posttraumatic arthrosis results in a reduced quality of life. Therefore, the treatment of a trimalleolar fractures is crucial. However, the treatment guidelines for posterior malleolar fractures (PMF) are still based on recommendations from 1940. Only a few retrospective studies have been conducted, which analysed patient outcomes based on lateral X-rays of the ankle...
October 2015: Injury
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