Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg GmbH, Location Marburg, Marburg, Germany.
Department of Orthopaedic and Trauma Surgery, University Hospital of Cologne, Cologne, Germany.
Foot Ankle Surg. 2019 Dec;25(6):766-770. doi: 10.1016/j.fas.2018.10.002. Epub 2018 Oct 23.
The incidence of geriatric ankle fractures continues to rise due to demographic changes. While locking plates have become standard implants for injuries of other body regions, clinical studies on their use for geriatric ankle fractures are rare.
Therefore, a retrospective case-control study, including 333 patients with a mean age of 73.5 years was performed. 263 patients underwent operative fixation with one- third tubular plates and 70 were treated with locking plates. Early outcomes and complication rates of locking plates as compared with conventional one- third tubular plates are described.
In the present study, patients treated with locking plates were older and suffered from more severe fracture patterns. In addition, these patients had more severe comorbidities. Treatment with conventional or locking plate fixation resulted in a comparable complication and revision rate. A matched pair analysis showed significantly more complications and required revision surgeries and a trend towards more implant failures in the group that underwent conventional plating.
Therefore, we conclude that precontoured locking plates represent an appropriate treatment option for severe ankle fractures in patients suffering from relevant co-morbidities. Prospective randomized trials are warranted to prove superiority of locking plates for treatment of geriatric ankle fractures. Level 3: Retrospective case- control study.
由于人口结构的变化，老年踝关节骨折的发病率持续上升。虽然锁定钢板已成为治疗其他身体部位损伤的标准植入物，但关于其在老年踝关节骨折中的应用的临床研究却很少。
因此，进行了一项回顾性病例对照研究，共纳入 333 例平均年龄为 73.5 岁的患者。263 例患者采用三分之一管状钢板进行手术固定，70 例患者采用锁定钢板治疗。描述了锁定钢板与传统三分之一管状钢板早期结果和并发症发生率的比较。
在本研究中，采用锁定钢板治疗的患者年龄更大，且骨折类型更严重。此外，这些患者合并症更严重。采用传统或锁定钢板固定治疗的并发症和翻修率相当。配对分析显示，接受传统钢板固定的患者组并发症更多，需要翻修手术，且植入物失败的趋势更为明显。
因此，我们得出结论，预成型锁定钢板是患有相关合并症的严重踝关节骨折患者的一种合适的治疗选择。需要前瞻性随机试验来证明锁定钢板在治疗老年踝关节骨折方面的优势。
3 级：回顾性病例对照研究。
