Resident, Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark.
Resident, Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark, Kolding, Denmark.
J Foot Ankle Surg. 2022 May-Jun;61(3):567-571. doi: 10.1053/j.jfas.2021.10.008. Epub 2021 Oct 23.
Locking plates were initially designed to provide improved stability to ankle fractures with poor bone quality but are currently widely used. The aim of this study was to compare the reoperation risk when using locking plates compared with nonlocking plates in patients with simple ankle fractures. This study was a population-based register study. Data regarding patients with AO type 44A1/2 and 44B1/2 injuries who were treated with either locking or nonlocking plates were obtained from the Danish Fracture Database. The follow-up period was 24 months. Major complications were defined as complications requiring surgical intervention, with the exception of simple hardware removal 6 weeks after primary surgery, which was defined as a minor complication. Multivariate regression analysis was performed to determine relative risk (RR), adjusted for age, sex, American Society of Anesthesiologists physical status classification (ASA)-score, and level of the surgeon's experience. A total of 2177 ankle fractures were included, among which 718 (33%) were treated with locking plates, and 1459 (67%) were treated with nonlocking plates. Data were linked with the Danish National Patient Registry to ensure complete information was obtained regarding reoperations, which were divided into major and minor complications. In both groups, the risks for major and minor complications were 3% and 22%, respectively, resulting in adjusted RRs of 1.00 (0.66; 1.66) for major reoperation comparing locking with nonlocking plates and 0.92 (0.76; 1.11) for minor reoperations. We conclude that no significant association with reoperation exists for locking compared with nonlocking plates among patients with surgically treated simple ankle fractures.
锁定板最初设计用于为骨质量差的踝关节骨折提供更好的稳定性，但目前已广泛使用。本研究旨在比较使用锁定板与非锁定板治疗单纯踝关节骨折患者的再次手术风险。这是一项基于人群的登记研究。从丹麦骨折数据库中获取了接受锁定或非锁定板治疗的 AO 型 44A1/2 和 44B1/2 损伤患者的数据。随访期为 24 个月。主要并发症定义为需要手术干预的并发症，但初次手术后 6 周的简单硬件移除除外，定义为轻微并发症。进行多变量回归分析以确定相对风险（RR），并调整年龄、性别、美国麻醉医师协会身体状况分类（ASA）评分和外科医生经验水平。共纳入 2177 例踝关节骨折，其中 718 例（33%）采用锁定板治疗，1459 例（67%）采用非锁定板治疗。将数据与丹麦国家患者登记处进行链接，以确保获得有关再次手术的完整信息，这些手术分为主要和次要并发症。在两组中，主要和次要并发症的风险分别为 3%和 22%，与非锁定板相比，锁定板的主要再手术调整 RR 为 1.00（0.66；1.66），次要再手术 RR 为 0.92（0.76；1.11）。我们的结论是，在接受手术治疗的单纯踝关节骨折患者中，与非锁定板相比，锁定板与再次手术之间没有显著关联。
