Fibular nails for open and closed ankle fractures: Results from a non-designer level I major trauma centre
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Author(s)
Al-Obaidi, Bilal
Wiik, Anatole Vilhelm
Bhattacharyya, Rahul
Mushtaq, Nadeem
Bhattacharya, Rajarshi
Type
Journal Article
Abstract
Aim:
To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a non-designer centre.
Methods:
In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Post-operative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications. Three patient reported outcome scores (Olerud and Molander score (OMAS), American Association of Orthopaedic Surgeons (AAOS) foot and ankle score and 12-Item Short Form Survey (SF-12)) were collected to obtain an overall measure of the patient’s physical and mental outcome.
Results:
The adequacy of reduction data was available for 38 of 39 cases; 33 (87%) achieved good, 3 (8%) fair and 2 (5%) poor ratings, based on the McLennan and Ungersma marking system. Thirty-five (12 open and 23 closed) patients were available for initial follow-up. Five (14.3%) of 35 had documented complications (2 of 12 in the open cohort and 3 of 23 in the closed cohort). All fibular fractures treated with the fibular nail went on to unite. Twenty-three (66%) of 35 patients were available at 1-year follow-up for measurement of objective outcome. The combined mean OMAS for both groups was 53.7 (0–85) with statistically better results (59.5 (25–85) vs. 37.3 (0–75)) in favour of the closed versus open injuries, respectively. The mean AAOS score was also statistically better for the closed group than the open, 70.3 (30–95) versus 46.6 (20–77), respectively. The mean SF-12 score (physical component) was 40 (21.6–52.4) in the closed group versus 36.1 (19.4–51.5) in the open group; the mean mental component was 42.5 (26.6–54.3) in the closed group versus 38.8 (28.4–60.5) in the open group, these however were not statistically different.
Conclusion:
Fibular nails are an effective alternative for the treatment for both closed and open unstable ankle fractures with soft tissue compromise.
To evaluate the outcome of a fibular nail in the treatment of open and closed unstable ankle fractures in a non-designer centre.
Methods:
In a retrospective cohort study, a total of 39 ankle fractures (14 open and 25 closed) treated with a locking fibular nail were evaluated between 2012 and 2015 in a non-designer level I major trauma centre. Post-operative radiographs were analysed to assess the quality of reduction (McLennan and Ungersma marking system), fracture union and complications. Three patient reported outcome scores (Olerud and Molander score (OMAS), American Association of Orthopaedic Surgeons (AAOS) foot and ankle score and 12-Item Short Form Survey (SF-12)) were collected to obtain an overall measure of the patient’s physical and mental outcome.
Results:
The adequacy of reduction data was available for 38 of 39 cases; 33 (87%) achieved good, 3 (8%) fair and 2 (5%) poor ratings, based on the McLennan and Ungersma marking system. Thirty-five (12 open and 23 closed) patients were available for initial follow-up. Five (14.3%) of 35 had documented complications (2 of 12 in the open cohort and 3 of 23 in the closed cohort). All fibular fractures treated with the fibular nail went on to unite. Twenty-three (66%) of 35 patients were available at 1-year follow-up for measurement of objective outcome. The combined mean OMAS for both groups was 53.7 (0–85) with statistically better results (59.5 (25–85) vs. 37.3 (0–75)) in favour of the closed versus open injuries, respectively. The mean AAOS score was also statistically better for the closed group than the open, 70.3 (30–95) versus 46.6 (20–77), respectively. The mean SF-12 score (physical component) was 40 (21.6–52.4) in the closed group versus 36.1 (19.4–51.5) in the open group; the mean mental component was 42.5 (26.6–54.3) in the closed group versus 38.8 (28.4–60.5) in the open group, these however were not statistically different.
Conclusion:
Fibular nails are an effective alternative for the treatment for both closed and open unstable ankle fractures with soft tissue compromise.
Date Issued
2019-02-25
Date Acceptance
2019-01-31
Citation
Journal of Orthopaedic Surgery, 2019, 27 (1)
ISSN
2309-4990
Publisher
SAGE Publications
Journal / Book Title
Journal of Orthopaedic Surgery
Volume
27
Issue
1
Copyright Statement
© 2019 The Author(s). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
Subjects
Gustillo–Anderson classification
ankle fractures
fibular nail
open fractures
1103 Clinical Sciences
Orthopedics
Publication Status
Published
Date Publish Online
2019-02-25