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短切口单一切口入路治疗外踝斜形骨折的防旋钢板固定:技术要点。

A short single-incision approach for antiglide plate fixation of oblique fractures of the lateral malleolus: a technical tip.

机构信息

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.

出版信息

Eur J Orthop Surg Traumatol. 2021 Feb;31(2):407-412. doi: 10.1007/s00590-020-02771-7. Epub 2020 Aug 17.


DOI:10.1007/s00590-020-02771-7
PMID:32804290
Abstract

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.

摘要

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。

相似文献

[1]
A short single-incision approach for antiglide plate fixation of oblique fractures of the lateral malleolus: a technical tip.

Eur J Orthop Surg Traumatol. 2021-2

[2]
Lateral malleolus closed reduction and internal fixation with intramedullary fibular rod using minimal invasive approach for the treatment of ankle fractures.

Foot Ankle Surg. 2019-2

[3]
[Application of lateral malleolus hook-plate in treatment of stage II supination-adduction type medial malleolus fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2014-9

[4]
[Minimally invasive fixation of distal fibular fractures with intramedullary nailing].

Oper Orthop Traumatol. 2021-4

[5]
True antiglide fixation of Danis-Weber B fibula fractures has lower rates of removal of hardware.

Injury. 2022-3

[6]
Surgical treatment of a displaced lateral malleolus fracture: the antiglide technique versus lateral plate fixation.

J Orthop Trauma. 2002-8

[7]
Modified use of proximal humeral interlocking plate (PHILOS) in lateral malleolus fracture, functional and radiological outcome in series of 13 cases.

Int J Surg. 2018-6-5

[8]
Antiglide plating of vertical medial malleolus fractures provides stiffer initial fixation than bicortical or unicortical screw fixation.

Clin Biomech (Bristol). 2016-1

[9]
[POSTEROLATERAL AND POSTEROMEDIAL APPROACHES FOR TREATMENT OF POSTERIOR Pilon FRACTURES IN ELDERLY PATIENTS].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016-9-8

[10]
Incidence of Peroneal Tendinopathy After Application of a Posterior Antiglide Plate for Repair of Supination External Rotation Lateral Malleolar Fractures.

J Foot Ankle Surg. 2016

引用本文的文献

[1]
Finite element analysis and a pilot study of different fixation constructs for Danis-Weber A and B lateral malleolus fractures.

BMC Musculoskelet Disord. 2023-12-19

[2]
Can CT-based assessment of lateral malleolus anatomy indicate when and how to perform an intramedullary fixation in distal fibula fractures? An analysis of 150 ankles.

Eur J Orthop Surg Traumatol. 2023-4

[3]
[Progress in diagnosis and treatment of fibular fracture in ankle fracture].

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022-1-15

本文引用的文献

[1]
Percutaneous Plating of Weber B Fibular Fractures.

J Foot Ankle Surg. 2017

[2]
Comparison of modern locked plating and antiglide plating for fixation of osteoporotic distal fibular fractures.

Foot Ankle Surg. 2016-9

[3]
Radiographic Evaluation of Ankle Joint Stability After Calcaneofibular Ligament Elevation During Open Reduction and Internal Fixation of Calcaneus Fracture.

Foot Ankle Int. 2016-9

[4]
Incidence of Peroneal Tendinopathy After Application of a Posterior Antiglide Plate for Repair of Supination External Rotation Lateral Malleolar Fractures.

J Foot Ankle Surg. 2016

[5]
Minimally invasive percutaneous plate osteosynthesis for ankle fractures: a prospective observational cohort study.

Eur J Orthop Surg Traumatol. 2014-10

[6]
Minimally invasive plate osteosynthesis in type B fibular fractures versus open surgery.

Musculoskelet Surg. 2013-12

[7]
Minimally invasive osteosynthesis of ankle fractures.

Pol Orthop Traumatol. 2012-11-20

[8]
Advancements in percutaneous fixation for foot and ankle trauma.

Clin Podiatr Med Surg. 2011-8

[9]
Surgical technique for minimally invasive fibula fracture fixation.

Foot Ankle Surg. 2010-3-25

[10]
Is fibular fracture displacement consistent with tibiotalar displacement?

Clin Orthop Relat Res. 2009-7-7

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