Retrograde Intramedullary Kirschner Wire Fixation as an Alternative for Treating Distal Fibular Shaft Fractures Combined with Distal Tibial Pilon Fractures

被引:2
作者
Huang, Cheng-Wei [1 ]
Wu, Wen-Tien [1 ,2 ]
Yu, Tsai-Chiu [1 ,2 ]
Chen, Ing-Ho [1 ,2 ]
Wang, Jen-Hung [3 ]
Yeh, Kuang-Ting [1 ,2 ]
机构
[1] Buddhist Tzu Chi Med Fdn, Hualien Tzu Chi Hosp, Dept Orthoped, Hualien 970473, Taiwan
[2] Tzu Chi Univ, Sch Med, Hualien 970374, Taiwan
[3] Buddhist Tzu Chi Med Fdn, Hualien Tzu Chi Hosp, Dept Med Res, Hualien 970473, Taiwan
来源
JOURNAL OF PERSONALIZED MEDICINE | 2022年 / 12卷 / 07期
关键词
distal fibular fracture; pilon fracture; retrograde intramedullary pinning; lateral distal tibial angle (LDTA); anterior distal tibial angle (ADTA); QUALITY-OF-LIFE; INTERNAL-FIXATION; OPEN REDUCTION; OUTCOMES; MANAGEMENT;
D O I
10.3390/jpm12071124
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Treatment or management techniques for pilon fractures are associated with high complication rates and poor outcomes. No consensus exists regarding the optimal surgical option for pilon fractures, especially for pilon fractures combined with distal fibular fractures. Accordingly, we explored the use of fibular fixation for treating pilon fractures involving distal fibular shaft fractures. We hypothesized that retrograde intramedullary Kirschner wire (K-wire) fixation is a suitable alternative technique for distal fibular fixation. We retrospectively reviewed the data of 156 patients who underwent surgery for pilon fractures at our hospital from May 2013 to May 2021. The radiographic and functional outcomes were comparable between the fibular intramedullary nailing (Group A; n = 80) and the fibular plating (Group B; n = 76) groups. Groups A and B differed significantly in total hospitalization time (11.4 vs. 18.2 days, p = 0.024), length of postoperative admission (6.8 vs. 11.4 days, p = 0.012), and total admission cost (USD 3624 vs. USD 6145, p = 0.004). We also noted that poor Olerud and Molander ankle scores were significantly associated with age (p = 0.008), smoking (p = 0.012), and preoperative admission length (p = 0.018). Retrograde intramedullary K-wire fixation produced a comparable 12-month functional outcome to plate fixation for distal fibular shaft fractures, rendering it a viable alternative method based on soft tissue condition.
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页数:9
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