Advertisement

International Orthopaedics

, Volume 31, Issue 6, pp 817–821 | Cite as

Lateral fixation of AO type-B2 ankle fractures in the elderly: the Knowles pin versus the plate

  • Yih-Shiunn LeeEmail author
  • Hui-Ling Huang
  • Ting-Ying Lo
  • Chien-Rae Huang
Original Paper

Abstract

The study was a retrospective evaluation and comparison. Seventy-five elderly patients (>50 years) with AO type-B2 ankle fractures were treated by open reduction and internal fixation. All patients were followed up retrospectively for at least 12 months. The 75 patients were divided into two groups, based on the method of treatment. The Knowles pin (KP) group included 45 patients with an average age of 62.7 years. The tubular plate (TP) group included 30 patients with an average age of 60.0 years. The clinical results were compared between the two groups. Both of the groups were similar in respect to the injury mechanisms, fracture pattern, open fracture grade, compounding medical conditions, and ankle score (all P values <0.28). However, the KP group had significantly smaller wound incisions, shorter surgery time, shorter hospital stay, less meperidine use, less symptomatic hardware, and lower complication rates than the TP group (all P values <0.03). In conclusion, lateral fixation of AO type-B2 ankle fractures in the elderly by the Knowles pin is recommended due to its simplicity, efficacy and low complication rate.

Keywords

Ankle Fracture Deltoid Ligament Soft Tissue Dissection Malleolar Fracture Delayed Wind Healing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Résumé

Etude rétrospective et comparative de 75 patients de plus de 50 ans avec une fracture malleolaire type B2 dans le système AO. Les patients, divisés en 2 groupes selon la méthode d’ostéosynthèse, avaient tous été suivis au moins un an. Le groupe traité par broche de Knowles (KP) comprenait 45 patients d’âge moyen 62.7 ans. Le groupe traité par plaque tubulaire comprenait 30 patients d’âge moyen 60 ans. Les 2 groupes étaient similaires pour le mécanisme fracturaire, le type de fracture, le degré d’ouverture, les conditions médicales, et le score fonctionnel (tous les P<0.28). Le groupe KP avait une plus petite incision cutanée, un temps opératoire plus court, une durée d’hospitalisation plus courte, moins de consommation d’antalgique, moins de gêne sur le matériel et un taux de complications plus faible que le groupe TP (tous les P<0.03). En conclusion nous recommandons la fixation des fractures de type AO B2 chez le sujet âgé par une broche de Knowles.

References

  1. 1.
    Baird RA, Jackson ST (1987) Fractures of the distal part of the fibula with associated disruption of the deltoid ligament. J Bone Joint Surg Am 69:1346–1352PubMedGoogle Scholar
  2. 2.
    Beauchamp CG, Clay NR, Thexton PW (1983) Displaced ankle fractures in patients over 50 years of age. J Bone Joint Surg Br 65(3):322–329Google Scholar
  3. 3.
    Brown OL, Dirschl DR, Obremskey WT (2001) Incidence of hardware-related pain and its effect on functional outcomes after open reduction and internal fixation of ankle fractures. J Orthop Trauma 15(4):271–274PubMedCrossRefGoogle Scholar
  4. 4.
    Fernandez GN (1988) Internal fixation of the oblique, osteoporotic fracture of the lateral malleolus. Injury 19(3):257–258PubMedCrossRefGoogle Scholar
  5. 5.
    Franklin JL, Johnson KD, Hansen ST Jr (1984) Immediate internal fixation of ankle fractures. J Bone Joint Surg Am 66(9):1349–1356PubMedGoogle Scholar
  6. 6.
    Griend RAV, Savoie FH, Hughes JL (1991) Fractures of the ankle. In: Rockwood CA Jr, Green DP, Bucholz RW (eds) Rockwood and Green’s fractures in adult: 1983–2030Google Scholar
  7. 7.
    Hammacher ER, Schutte PR, Bast TJ (1986) Minimal osteosynthesis of lateral malleolar fractures. Neth J Surg 38(3):87–89PubMedGoogle Scholar
  8. 8.
    Koval KJ, Petraco DM, Kummer FJ et al (1997) A new technique for complex fibula fracture fixation in the elderly: a clinical and biomechanical evaluation. J Orthop Trauma 11(1):28–33PubMedCrossRefGoogle Scholar
  9. 9.
    Lamontagne J, Blachut PA, Broekhuyse HM et al (2002) Surgical treatment of a displaced lateral malleolus fracture. J Orthop Trauma 16:498–502PubMedCrossRefGoogle Scholar
  10. 10.
    Litchfield JC (1987) The treatment of unstable fracture of the ankle in the elderly. Injury 18:128–132PubMedCrossRefGoogle Scholar
  11. 11.
    Lee YS, Huang CC, Chen CN et al (2005) Operative treatment of displaced lateral malleolar fractures. The Knowles pin technique. J Orthop Trauma 19:192–197PubMedCrossRefGoogle Scholar
  12. 12.
    Mcdade WC (1975) Treatment of ankle fractures. In: AAOS Instructional Course Lectures, Ch 14. St. Louis, C.V. Mosby; 251–294Google Scholar
  13. 13.
    Mclennan JG, Ungersma JA (1986) A new approach to the treatment of ankle fractures. Clin Orthop 213:125–136PubMedGoogle Scholar
  14. 14.
    Olerud C, Molander H (1986) Bi- and trimalleolar ankle fractures operated with nonrigid internal fixation. Clin Orthop 206:253–260PubMedGoogle Scholar
  15. 15.
    Phillips WA, Schwartz HS, Keller CS et al (1985) A prospective randomized study of the management of severe ankle fractures. J Bone Joint Surg Am 67:67–78PubMedGoogle Scholar
  16. 16.
    Ramasamy PR, Sherry P (2001) The role of a fibular nail in the management of Weber type B ankle fractures in elderly patients with osteoporotic bone. Injury 32:477–485PubMedCrossRefGoogle Scholar
  17. 17.
    Weber BG, Simpson LA (1985) Corrective lengthening osteotomy of the fibula. Clin Orthop 199:61–67PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Yih-Shiunn Lee
    • 1
    Email author
  • Hui-Ling Huang
    • 1
  • Ting-Ying Lo
    • 1
  • Chien-Rae Huang
    • 1
  1. 1.Department of Orthopedic SurgeryTaipei City HospitalTaipeiRepublic of China

Personalised recommendations