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

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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.

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.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Taipei City Hospital, Heping Branch, No. 33, Section 2, Chung-Hwa Rd, Taipei, Taiwan, Republic of China

    Yih-Shiunn Lee, Hui-Ling Huang, Ting-Ying Lo & Chien-Rae Huang

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  1. Yih-Shiunn Lee
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  2. Hui-Ling Huang
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  3. Ting-Ying Lo
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  4. Chien-Rae Huang
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Correspondence to Yih-Shiunn Lee.

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Lee, YS., Huang, HL., Lo, TY. et al. Lateral fixation of AO type-B2 ankle fractures in the elderly: the Knowles pin versus the plate. International Orthopaedics (SICO 31, 817–821 (2007). https://doi.org/10.1007/s00264-006-0260-2

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  • DOI: https://doi.org/10.1007/s00264-006-0260-2

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