Department of Orthopaedics, Foot and Ankle Surgery, University of São Paulo (HC FMRP-USP), Ribeirão Preto, SP, Brazil.
Department of Orthopaedics, Foot and Ankle Surgery, Hospital of the Municipal Public Servant of São Paulo (HSPM), São Paulo, SP, Brazil.
Eur J Orthop Surg Traumatol. 2021 Feb;31(2):407-412. doi: 10.1007/s00590-020-02771-7. Epub 2020 Aug 17.
Displaced fractures (> 2 mm) of the lateral malleolus, without medial or syndesmotic injuries, are often the subject of controversy regarding the best treatment option. In the past, these fractures were usually treated conservatively using a cast for 6 to 8 weeks without weightbearing. Currently, most of the patients desire a quick return to their previous activities, what makes surgical treatment a reasonable choice. It has benefits as earlier ankle mobilization and weightbearing. It also restores ankle biomechanics, preventing secondary osteoarthritis. However, postoperative complications with the standard lateral incision exist such as implant discomfort, dehiscence and infection. Minimally invasive techniques have been described to help avoiding these complications. This technical note described a short single-incision approach for the surgical treatment of displaced oblique fibular fractures type AO/OTA 44-B1 with an antiglide plate that presents the advantage of less risk of damaging the soft tissues, periosteal stripping and disturbance of the fracture hematoma.
外踝的移位骨折（>2 毫米），无内踝或下胫腓联合损伤，通常是最佳治疗选择的争议焦点。过去，这些骨折通常采用保守治疗，使用石膏固定 6 至 8 周，不负重。目前，大多数患者希望快速恢复到以前的活动水平，这使得手术治疗成为一种合理的选择。它具有早期踝关节活动和负重的优点。它还可以恢复踝关节的生物力学，预防继发性骨关节炎。然而，标准外侧切口的术后并发症如植入物不适、裂开和感染仍然存在。微创技术已被描述用于帮助避免这些并发症。本技术说明描述了一种短的单切口方法，用于治疗 AO/OTA 44-B1 型的外踝斜形骨折，使用了抗滑钢板，其优点是软组织损伤、骨膜剥离和骨折血肿干扰的风险较小。
