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

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Abstract

Forty-seven patients with open lateral malleolar (AO type-B2) fractures treated with copious irrigation and radical debridement, reduction, and immediate fixation by Knowles pins or lateral plates were retrospectively reviewed with an average follow-up period of 29 months. The 47 patients were divided into two groups, based on the method of treatment. The Knowles pin group included 25 patients. The plate group included 22 patients. There was no difference between the Knowles pinning and lateral plating with respect to the rate of good reduction (96% vs. 95.5%, p = 1). Both of the groups were similar in good and excellent results (92% vs. 86.4%, p = 0.65). However, Knowles pinning had significantly shorter operation time, smaller wound size, less symptomatic hardware, and lower complication rate than lateral plating (all p values <0.04). In conclusion, lateral fixation of open AO type-B2 ankle fractures by the Knowles pin is recommended due to its efficacy, simplicity, and low complication rate.

Résumé

Quarante sept patients avec une fracture ouverte de la malléole externe (type AO: B2), traités par débridement, réduction et fixation par broches de Knowles ou par plaque étaient étudiés rétrospectivement avec un recul moyen de 29 mois. Les patients étaient divisés en deux groupes: le groupe des broches incluait 25 patients et le groupe des plaques incluait 22 patients. Le taux de bonnes réductions n’était pas différent (96% vs 95,5%, p = 1). Les deux groupes étaient similaires pour le taux de bons résultats (92% vs 86,4%, p = 0,65). Cependant la synthèse par broches avait un temps opératoire plus court, une incision plus petite, moins de gêne liée au matériel et un taux de complication plus faible que la synthèse par plaque. En conclusion l’ostéosynthèse externe par broches des fractures ouvertes de la cheville type AO-B2 est recommandée pour son efficacité, sa simplicité et son faible taux de complication.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Lin Shin Hospital, No. 36, Huizhong Rd., Nanton District, Taichung City, 408, Taiwan

    Yih-Shiunn Lee

  2. Department of Nursing, Central Taiwan University of Science and Technology, No. 11, Pu-Tzu Lane, Pei-tun District, Taichung City, 40601, Taiwan

    Yih-Shiunn Lee & Shu-Wen Chen

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  1. Yih-Shiunn Lee
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  2. Shu-Wen Chen
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Correspondence to Yih-Shiunn Lee.

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Lee, YS., Chen, SW. Lateral fixation of open AO type-B2 ankle fractures: the Knowles pin versus plate. International Orthopaedics (SICOT) 33, 1135–1139 (2009). https://doi.org/10.1007/s00264-008-0617-9

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  • DOI: https://doi.org/10.1007/s00264-008-0617-9

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