When Should Open Reduction and Internal Fixation Ankle Fractures Begin Weight Bearing? A Systematic Review

2007 ◽  
Vol 34 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Toby O. Smith ◽  
Leigh Davies
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Ankle Fractures

Treatment options for unstable ankle fractures in older adults: A systematic review and meta-analysis

Trauma ◽  
2020 ◽  
pp. 146040862093797
Author(s):  
Andrew Grazette ◽  
Catrin Wigley ◽  
Andrew Metcalfe
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Internal Fixation ◽  
Open Reduction ◽  
Meta Analysis ◽  
Treatment Options ◽  
Ankle Fractures ◽  
Treatment Modalities ◽  
Current Evidence ◽  
Treatment Groups

Background Ankle fractures are the third most common fracture in the elderly. Patients over 60 years are more severely affected by these injuries than their younger counterparts and have a higher rate of complications regardless of the management strategy. Traditional management strategies for unstable ankle fractures include plaster immobilisation and open reduction and internal fixation, with newer modalities such as intramedullary fixation becoming increasingly popular. The aim of this review is to establish the best current evidence for or against different treatment strategies. Methods A systematic review and meta-analysis of randomised controlled trials comparing treatment options for unstable ankle fractures in adults over 55 was conducted, with the primary outcome being functional assessment score at 6–12 months (Olerud and Molander Ankle Score). Secondary outcomes were adverse events including infection and re-operation. Results The search strategies identified 426 articles. After screening and full text review, four papers met the inclusion and exclusion criteria, providing data on 754 ankle fractures. Alternative treatment groups were tibio-talo-calcaneal nail, fibular nail and casting and were compared to open reduction and internal fixation. Meta-analysis of the data showed no difference in Olerud and Molander Ankle Score between treatment modalities at 6–12 months. There was, however, a significant reduction in the incidence of adverse events (OR 0.59 (0.44, 0.81)) and wound infection (0.13 (0.05, 0.31)) in the alternative treatment groups compared to open reduction and internal fixation. Conclusion The current evidence shows no significant difference between treatment modalities for ankle fractures in older adults in terms of functional outcome. Open reduction and internal fixation has a higher rate of adverse events and wound infection when compared to alternative treatments. Therefore, surgery should be carefully considered and if undertaken, in a select patient cohort other treatment modalities, such as intramedullary fixation should be considered.

scholarly journals Study on functional outcome of bimalleolar ankle fractures treated by open reduction and internal fixation

2021 ◽  
Vol 7 (3) ◽  
pp. 518
Author(s):  
Nithin Gangadhran ◽  
Manju G. Pillai
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
External Rotation ◽  
Outcome Measurement ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Cortical Screw ◽  
Articular Fractures ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.</p><p class="abstract"><strong>Methods:</strong> 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.</p><p class="abstract"><strong>Conclusions:</strong> The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.</p><p class="abstract"> </p>

Effect of Early Weight Bearing on Outcomes After Open Reduction and Internal Fixation of Trimalleolar Ankle Fractures

Orthopedics ◽  
2021 ◽  
Author(s):  
Devon M. Myers ◽  
Sergio H. Pulido ◽  
Shane Forsting ◽  
Benjamin Umbel ◽  
Benjamin C. Taylor
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Early Weight Bearing

Comparison of immobilization periods following open reduction and internal fixation of distal radius fracture: A systematic review and meta-analysis

2021 ◽  
Author(s):  
Abdullah A. Ghaddaf ◽  
Ahmed S. Abdulhamid ◽  
Mohammed S. Alomari ◽  
Mohammed S. Alquhaibi ◽  
Abdulaziz A. Alshehri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Open Reduction ◽  
Meta Analysis ◽  
Radius Fracture

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

scholarly journals Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Sohail Yousaf ◽  
Daniel Hay
Keyword(s):  
Systematic Review ◽  
External Rotation ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Controlled Trials ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Stress Radiographs ◽  
The Stability ◽  
Supination External Rotation

Category: Trauma Introduction/Purpose: Differentiating stable isolated fibula fractures consistent with supination external rotation (SER) II ankle fractures from unstable SER IV fractures is essential in determining the need for surgical stabilisation. Stress radiographs are usually required to assess stability including gravity stress views (GSV) and external rotation views (ER). There is no clear consensus as to which modality is most useful to determine stability in a fracture clinic or emergency setting. In last, few years clinical uncertainty about the reliability has led researcher to focus on weight bearing radiographs (WB) .We aim to review recent literature regarding reliability of WB radiographs to estimate the stability of supination external rotation ankle fractures. Methods: A systematic review of the literature relating to radiological assessment of stability of supination external rotation ankle fractures was conducted according to PRISMA guidelines. The systematic review was prospectively registered with PROSPERO. It involved the following steps: Researching the question-Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture? Setting inclusion and exclusion criteria-All English language articles published in the including any Randomised controlled trials (RCT’s) and cohort studies. Data collection)– A literature search of Medline (PubMed), the Cochrane Bone, Joint, and Muscle Trauma Group trial register, the Cochrane central register of controlled trials, Embase and CINAHL was undertaken. The grey literature was searched. Key terms ‘supination external rotation fracture’, ‘stability’. Other variations to the key words were ‘weight bearing’, “axial load”, ‘stress x-rays’, ‘systematic reviews’ and ‘meta-analysis’. Results: A total of six studies met the inclusion criteria including 601 patients. No previous systematic review on stress radiographs including weight bearing was published. All studies concluded weight bearing radiographs is an easy, pain-free, safe and reliable method to estimate stability of isolated distal fibula fractures. No serious concerns or complications were reported. Conclusion: The evidence base contained many methodological limitations and most of the evidence was either level III or IV, and so any conclusion drawn from the research must be done so with caution. The studies suggest that GSV overestimates the instability which should be assessed with studies should focus on randomized controlled trials with narrow range of clinically useful outcome measures.

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