Syndesmotic fixation in unstable ankle fractures: Does early post-operative weight bearing affect radiographic outcomes?

被引:11
作者
Al-Hourani, K. [1 ]
Stoddart, M. [1 ]
Chesser, T. J. S. [1 ]
机构
[1] Southmead Hosp, Dept Trauma & Orthopaed Surg, Bristol BS10 5NB, Avon, England
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2019年 / 50卷 / 03期
关键词
Trauma; Ankle; Syndesmosis; Radiograph; Outcomes; Weight; Bear; Immobilization; Diastasis; EARLY MOBILIZATION; SCREW FIXATION; TIBIOFIBULAR SYNDESMOSIS; STAINLESS-STEEL; INJURIES; EPIDEMIOLOGY; BIMALLEOLAR; REDUCTION; ROTATION;
D O I
10.1016/j.injury.2019.02.014
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Objective: To analyse whether early post-operative full weight bearing following syndesmotic ankle fixation affected radiographic outcomes suggestive of diastasis. Design: Retrospective comparative cohort study over a two year period. Setting: Level 1 trauma centre Patients/Participants: 152 consecutive patients sustaining an unstable ankle fracture requiring syndesmotic stabilisation were included. Exclusions were 49 patients who had trimalleolar fixation without syndesmosis screws, one patient who had concomitant ankle and talar fracture. Five patients were lost to follow up and eleven patients were followed up in other centres. A total of 86 patients were analysed Intervention: Protected or full weight bearing. Main Outcome Measurement: The primary outcome measure was early diastasis. The secondary outcomes were late diastasis, wound complications and re-operation. Analysis of variance was used for the predictor variable of weight bearing status. We assumed a priori that p values of less than 0.05 were significant. Results: Median age was 36 (IQR 30), with 54 males and 32 females. Median follow up was 12 weeks (IQR 6). There was no significant difference when comparing weight bearing status and change in radiographic measurements intra-operatively compared to 6 and 12 week follow up radiographs (tibiofibular clear space p = 0.799, tibiofibular overlap p = 0.733 and medial clear space p = 0.261). Conclusion: After surgical stabilization ofan unstable syndesmotic injury, full weight bearing did not lead to syndesmotic diastasis in the early post-operative period. Full weight bearing is recommended following ankle fixation which includes syndesmotic fixation. (C) 2019 Elsevier Ltd. All rights reserved.
引用
收藏
页码:790 / 795
页数:6
相关论文
共 44 条
  • [1] EARLY MOBILIZATION OF OPERATED ON ANKLE FRACTURES - PROSPECTIVE, CONTROLLED-STUDY OF 40 BIMALLEOLAR CASES
    AHL, T
    DALEN, N
    LUNDBERG, A
    BYLUND, C
    [J]. ACTA ORTHOPAEDICA SCANDINAVICA, 1993, 64 (01): : 95 - 99
  • [2] EARLY WEIGHT BEARING OF DISPLACED ANKLE FRACTURES
    AHL, T
    DALEN, N
    HOLMBERG, S
    SELVIK, G
    [J]. ACTA ORTHOPAEDICA SCANDINAVICA, 1987, 58 (05): : 535 - 538
  • [3] EARLY WEIGHT BEARING OF MALLEOLAR FRACTURES
    AHL, T
    DALEN, N
    HOLMBERG, S
    SELVIK, G
    [J]. ACTA ORTHOPAEDICA SCANDINAVICA, 1986, 57 (06): : 526 - 529
  • [4] Syndesmotic screw fixation in Weber C ankle injuries-should the screw be removed before weight bearing?
    Bell, David Paul
    Wong, Merng Koon
    [J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2006, 37 (09): : 891 - 898
  • [5] Screw fixation of the syndesmosis: a cadaver model comparing stainless steel and titanium screws and three and four cortical fixation
    Beumer, A
    Campo, MM
    Niesing, R
    Day, J
    Kleinrensink, GJ
    Swierstra, BA
    [J]. INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2005, 36 (01): : 60 - 64
  • [6] Observer reliability in ankle radiographic measurements
    Brage, ME
    Bennet, CR
    Whitehurst, JB
    Getty, PJ
    Toledano, A
    [J]. FOOT & ANKLE INTERNATIONAL, 1997, 18 (06) : 324 - 329
  • [7] TREATMENT OF UNSTABLE ANKLE FRACTURES
    BRODIE, IAOD
    DENHAM, RA
    [J]. JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 1974, B 56 (02): : 256 - 262
  • [8] Comparison study of two surgical options for distal tibia fracture-minimally invasive plate osteosynthesis vs. open reduction and internal fixation
    Cheng, Wang
    Li, Ying
    Manyi, Wang
    [J]. INTERNATIONAL ORTHOPAEDICS, 2011, 35 (05) : 737 - 742
  • [9] CHISSELL HR, 1995, J BONE JOINT SURG BR, V77B, P435
  • [10] CIMINO W, 1991, CLIN ORTHOP RELAT R, P152