Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures
OBJECTIVE: To compare the clinical outcome and postoperative complications of the treatment of supination-external rotation-type ankle fractures using the posterolateral approach in the prone position and the lateral approach in the supine position. METHODS: A retrospective cohort study was conducte...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Hindawi
2022
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015882/ https://www.ncbi.nlm.nih.gov/pubmed/35444779 http://dx.doi.org/10.1155/2022/7726726 |
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author | Chen, Bingqian Wang, Zhengfei Chen, Zhi Qu, Xiaohong Fang, Xiaowen Wang, Xuesong Ke, Guoxiu |
author_facet | Chen, Bingqian Wang, Zhengfei Chen, Zhi Qu, Xiaohong Fang, Xiaowen Wang, Xuesong Ke, Guoxiu |
author_sort | Chen, Bingqian |
collection | PubMed |
description | OBJECTIVE: To compare the clinical outcome and postoperative complications of the treatment of supination-external rotation-type ankle fractures using the posterolateral approach in the prone position and the lateral approach in the supine position. METHODS: A retrospective cohort study was conducted in our hospital, including a total of 66 patients ranging from January 2013 to February 2016, regardless of age or sex. All the patients were classified as Lauge-Hansen supination-external rotation (SER)-type ankle fractures and were assigned to receive an open reduction and internal fixation (ORIF) through a posterolateral approach performed in the prone position (the “posterolateral approach group,” 32 patients), or a lateral approach performed in the supine position (the “Lateral Approach Group,” 34 patients). In the posterolateral approach group, 5 patients had Grade II fractures, 8 had Grade III fractures, and 19 had Grade IV fractures; among whom, 12 underwent fixation of the posterior malleolus with hollow screws and 6 with plates, and none of them had fixation of the distal tibiofibular syndesmosis; in the lateral approach group, 4 patients had Grade II fractures, 12 had Grade III fractures, and 18 had Grade IV fractures; among whom, 21 received fixation of the posterior malleolus, and 5 received fixation of the distal tibiofibular syndesmosis. The postoperative complications and ankle scores were recorded. RESULTS: After 1 year of follow-up, in the posterolateral approach group, the incision healed by primary intention and sutures were removed 2 weeks after the operation in all patients; 1 patient had pain in the region posterior to the fibula, presumably peroneal tendon irritation induced by internal fixation, which disappeared after fracture union and fixation device removal; no loosening or breakage of the internal fixation device was reported; the rate of good to excellent results was 96.8% at 12 months. In the lateral approach group: 1 case of wound infection, 1 case of necrosis of lateral skin flap, and 3 cases of lateral skin irritation were reported; the rate of good to excellent results was 94.6% at 12 months. CONCLUSION: Compared with the traditional lateral approach, the posterolateral approach for the reduction and internal fixation of supination-external rotation-type ankle fractures performed in the prone position has more satisfactory clinical outcomes, with better reduction, more secure fixation, and smaller wound. |
format | Online Article Text |
id | pubmed-9015882 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-90158822022-04-19 Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures Chen, Bingqian Wang, Zhengfei Chen, Zhi Qu, Xiaohong Fang, Xiaowen Wang, Xuesong Ke, Guoxiu J Healthc Eng Research Article OBJECTIVE: To compare the clinical outcome and postoperative complications of the treatment of supination-external rotation-type ankle fractures using the posterolateral approach in the prone position and the lateral approach in the supine position. METHODS: A retrospective cohort study was conducted in our hospital, including a total of 66 patients ranging from January 2013 to February 2016, regardless of age or sex. All the patients were classified as Lauge-Hansen supination-external rotation (SER)-type ankle fractures and were assigned to receive an open reduction and internal fixation (ORIF) through a posterolateral approach performed in the prone position (the “posterolateral approach group,” 32 patients), or a lateral approach performed in the supine position (the “Lateral Approach Group,” 34 patients). In the posterolateral approach group, 5 patients had Grade II fractures, 8 had Grade III fractures, and 19 had Grade IV fractures; among whom, 12 underwent fixation of the posterior malleolus with hollow screws and 6 with plates, and none of them had fixation of the distal tibiofibular syndesmosis; in the lateral approach group, 4 patients had Grade II fractures, 12 had Grade III fractures, and 18 had Grade IV fractures; among whom, 21 received fixation of the posterior malleolus, and 5 received fixation of the distal tibiofibular syndesmosis. The postoperative complications and ankle scores were recorded. RESULTS: After 1 year of follow-up, in the posterolateral approach group, the incision healed by primary intention and sutures were removed 2 weeks after the operation in all patients; 1 patient had pain in the region posterior to the fibula, presumably peroneal tendon irritation induced by internal fixation, which disappeared after fracture union and fixation device removal; no loosening or breakage of the internal fixation device was reported; the rate of good to excellent results was 96.8% at 12 months. In the lateral approach group: 1 case of wound infection, 1 case of necrosis of lateral skin flap, and 3 cases of lateral skin irritation were reported; the rate of good to excellent results was 94.6% at 12 months. CONCLUSION: Compared with the traditional lateral approach, the posterolateral approach for the reduction and internal fixation of supination-external rotation-type ankle fractures performed in the prone position has more satisfactory clinical outcomes, with better reduction, more secure fixation, and smaller wound. Hindawi 2022-04-11 /pmc/articles/PMC9015882/ /pubmed/35444779 http://dx.doi.org/10.1155/2022/7726726 Text en Copyright © 2022 Bingqian Chen et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Chen, Bingqian Wang, Zhengfei Chen, Zhi Qu, Xiaohong Fang, Xiaowen Wang, Xuesong Ke, Guoxiu Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title | Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title_full | Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title_fullStr | Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title_full_unstemmed | Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title_short | Comparison of Two Surgical Approaches to Supination-External Rotation-Type Ankle Fractures |
title_sort | comparison of two surgical approaches to supination-external rotation-type ankle fractures |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9015882/ https://www.ncbi.nlm.nih.gov/pubmed/35444779 http://dx.doi.org/10.1155/2022/7726726 |
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