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...

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Autores principales: Chen, Bingqian, Wang, Zhengfei, Chen, Zhi, Qu, Xiaohong, Fang, Xiaowen, Wang, Xuesong, Ke, Guoxiu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
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.
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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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