Cargando…
Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship?
CATEGORY: Trauma; Ankle INTRODUCTION/PURPOSE: Fibular nailing (FN) is a method of fixation that has proven to be useful for the treatment of distal fibular fractures (DF). FN minimizes soft tissue complications, provides similar stability compared to plating with less hardware related symptoms. Neve...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564937/ http://dx.doi.org/10.1177/2473011420S00003 |
_version_ | 1784593715155697664 |
---|---|
author | Mikenberg, Natalio R. Cuchacovich Gallardo, Francisco J. Bravo Giannini, Esteban Astudillo, Claudia Pellegrini, Manuel J. Muñoz, Gerardo Melo, Rodrigo Cortes, Aaron Bastias, Gonzalo F. |
author_facet | Mikenberg, Natalio R. Cuchacovich Gallardo, Francisco J. Bravo Giannini, Esteban Astudillo, Claudia Pellegrini, Manuel J. Muñoz, Gerardo Melo, Rodrigo Cortes, Aaron Bastias, Gonzalo F. |
author_sort | Mikenberg, Natalio R. Cuchacovich |
collection | PubMed |
description | CATEGORY: Trauma; Ankle INTRODUCTION/PURPOSE: Fibular nailing (FN) is a method of fixation that has proven to be useful for the treatment of distal fibular fractures (DF). FN minimizes soft tissue complications, provides similar stability compared to plating with less hardware related symptoms. Nevertheless, FN has been associated with syndesmotic malreduction and incapacity of restoring length and rotation of the fibula. We aimed to evaluate the fibular and syndesmotic reduction after fixation with FN compared to the uninjured ankle. METHODS: Prospective cohort, cross-sectional study with a paired control group. Patients with DF fractures treated with FN between January 2017 and July 2019 were included. Immediate postoperative bilateral Ankle CT was obtained in all cases. Two independent radiologists performed all the measurements on both ankles (fibular rotation, length, translation, and syndesmotic diastasis. Statistical analysis was made using the Wilcoxon Test and Intraclass correlation coefficient (ICC). Considering a medium size sample effect, 95% confidence with .05 alpha error, a total sample of 26 subjects were needed to achieve a .80 of statistical power (G-Power 3.1). All analyses were performed using SPSS V20. RESULTS: Twenty-six patients were included (14 Women). The mean age was 47 years (18-91). No statistically significant differences were identified considering fibular rotation (p:0,694), fibular length (p:0,585) and syndesmotic diastasis (p:0,078) between the injured and uninjured ankle. Fibular translation has statistical differences (p:0,043). The ICC shows an excellent concordance between radiologists except for Fibular translation (ICC 0,47) CONCLUSION: In this cohort, fixation of DF fractures with FN allows restoration of anatomical parameters of the ankle in terms of fibular rotation, length, and syndesmotic diastasis. However, Fibular translation had significant differences compared with the uninjured ankle. |
format | Online Article Text |
id | pubmed-8564937 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-85649372022-01-28 Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? Mikenberg, Natalio R. Cuchacovich Gallardo, Francisco J. Bravo Giannini, Esteban Astudillo, Claudia Pellegrini, Manuel J. Muñoz, Gerardo Melo, Rodrigo Cortes, Aaron Bastias, Gonzalo F. Foot Ankle Orthop Article CATEGORY: Trauma; Ankle INTRODUCTION/PURPOSE: Fibular nailing (FN) is a method of fixation that has proven to be useful for the treatment of distal fibular fractures (DF). FN minimizes soft tissue complications, provides similar stability compared to plating with less hardware related symptoms. Nevertheless, FN has been associated with syndesmotic malreduction and incapacity of restoring length and rotation of the fibula. We aimed to evaluate the fibular and syndesmotic reduction after fixation with FN compared to the uninjured ankle. METHODS: Prospective cohort, cross-sectional study with a paired control group. Patients with DF fractures treated with FN between January 2017 and July 2019 were included. Immediate postoperative bilateral Ankle CT was obtained in all cases. Two independent radiologists performed all the measurements on both ankles (fibular rotation, length, translation, and syndesmotic diastasis. Statistical analysis was made using the Wilcoxon Test and Intraclass correlation coefficient (ICC). Considering a medium size sample effect, 95% confidence with .05 alpha error, a total sample of 26 subjects were needed to achieve a .80 of statistical power (G-Power 3.1). All analyses were performed using SPSS V20. RESULTS: Twenty-six patients were included (14 Women). The mean age was 47 years (18-91). No statistically significant differences were identified considering fibular rotation (p:0,694), fibular length (p:0,585) and syndesmotic diastasis (p:0,078) between the injured and uninjured ankle. Fibular translation has statistical differences (p:0,043). The ICC shows an excellent concordance between radiologists except for Fibular translation (ICC 0,47) CONCLUSION: In this cohort, fixation of DF fractures with FN allows restoration of anatomical parameters of the ankle in terms of fibular rotation, length, and syndesmotic diastasis. However, Fibular translation had significant differences compared with the uninjured ankle. SAGE Publications 2020-07-07 /pmc/articles/PMC8564937/ http://dx.doi.org/10.1177/2473011420S00003 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Article Mikenberg, Natalio R. Cuchacovich Gallardo, Francisco J. Bravo Giannini, Esteban Astudillo, Claudia Pellegrini, Manuel J. Muñoz, Gerardo Melo, Rodrigo Cortes, Aaron Bastias, Gonzalo F. Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title | Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title_full | Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title_fullStr | Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title_full_unstemmed | Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title_short | Does Intramedullary Nailing for Distal Fibular Fractures Restore Anatomic Parameters and Syndesmotic Relationship? |
title_sort | does intramedullary nailing for distal fibular fractures restore anatomic parameters and syndesmotic relationship? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8564937/ http://dx.doi.org/10.1177/2473011420S00003 |
work_keys_str_mv | AT mikenbergnataliorcuchacovich doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT gallardofranciscojbravo doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT gianniniesteban doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT astudilloclaudia doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT pellegrinimanuelj doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT munozgerardo doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT melorodrigo doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT cortesaaron doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship AT bastiasgonzalof doesintramedullarynailingfordistalfibularfracturesrestoreanatomicparametersandsyndesmoticrelationship |