Open reduction and internal fixation of the posterior malleolus fragment via the posterolateral approach is radiologically superior to ‘A to P’ screw fixation

The Foot ◽  
2021 ◽  
pp. 101894
Author(s):  
Samuel Marinus Verhage ◽  
Alexander Leijdesdorff ◽  
Inger Birgitta Schipper ◽  
Jochem Maarten Hoogendoorn
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Screw Fixation ◽  
Posterolateral Approach ◽  
Posterior Malleolus

Open Reduction Internal Fixation of Posterior Malleolus Fractures and Iatrogenic Injuries

2016 ◽  
Vol 9 (6) ◽  
pp. 527-533 ◽  
Author(s):  
John A. Karbassi ◽  
Andrew Braziel ◽  
Peter K. Garas ◽  
Abhay R. Patel
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Articular Surface ◽  
Open Reduction Internal Fixation ◽  
Iatrogenic Injury ◽  
Posterolateral Approach ◽  
Anatomical Structures ◽  
Posterior Malleolus ◽  
Extensor Hallucis Longus ◽  
K Wires

Open reduction internal fixation of posterior malleolus fractures from a posterior approach is gaining popularity. One concern that has not been studied is the risk of iatrogenic injury to anatomical structures on the anterior ankle. The purpose of this study is to determine the proximity of these anterior structures with relation to K-wires advanced through the anterior cortex. A total of 10 cadaver ankles were utilized in the study. A posterolateral approach to the ankle was used. K-wires were advanced at varying levels above the articular surface, and then, the proximity of the wires to the following structures was determined: the neurovascular bundle, tibialis anterior (TA), and extensor hallucis longus. Overall, the structure most in danger of being injured was the TA (P < .001). This tendon was injured by 52% of all K-wires. These data suggest that K-wires should be advanced under direct fluoroscopic visualization to minimize the risk of iatrogenic injury. Levels of Evidence: Level IV

scholarly journals Incidence of early complications in the posterolateral approach to posterior malleolus fractures

2020 ◽  
Vol 14 (2) ◽  
pp. 178-182
Author(s):  
Camilo Miranda de Pinho Tavares ◽  
Rodrigo Simões Castilho ◽  
Fernando Araújo Silva Lopes ◽  
Daniel Soares Baumfeld ◽  
Thiago Alexandre Alves Silva ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Learning Curve ◽  
Internal Fixation ◽  
Open Reduction ◽  
Fracture Dislocation ◽  
Posterolateral Approach ◽  
Complication Rates ◽  
Early Complications ◽  
Posterior Malleolus ◽  
Delayed Healing

Introduction: To ascertain the incidence of early complications in the posterolateral approach to open reduction and internal fixation of posterior malleolar fractures and identify possible risk factors related to occurrence of these complications. Methods: Retrospective study carried out in three tertiary hospitals. Patients who underwent open reduction and internal fixation of posterior malleolus fractures via the posterolateral route were divided into two groups: with versus without delayed postoperative healing. To assess risk and protective factors for the outcome of delayed healing, we evaluated the time between trauma and surgery, whether the patient had a fracture-dislocation of the ankle, and whether external fixation was performed before surgery. We also evaluated whether improvement in operative technique led to a reduction in complication rates. Results: A total of 43 individuals who underwent surgical correction of posterior malleolus fractures via the posterolateral route between 2013 and 2018 were included. Of these, 19 (44.2%) had skin complications that led to delayed healing. Skin complications occurred more frequently at the beginning of the learning curve of the surgeons involved; the incidence up to the year 2016 was 56.3%, decreasing significantly to 37% from 2017 onward. Conclusion: Patients who undergo open reduction and internal fixation of posterior malleolus fractures via the posterolateral route at the beginning of the learning curve are a greater risk of developing skin complications, demonstrating the importance of this approach being restricted to more experienced surgeons. Level of Evidence III; Prognostic Studies; Retrospective Study.

Open reduction and internal fixation of posterior malleolar fractures using the posterolateral approach

2016 ◽  
Vol 98-B (6) ◽  
pp. 812-817 ◽  
Author(s):  
S. M. Verhage ◽  
F. Boot ◽  
I. B. Schipper ◽  
J. M. Hoogendoorn
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Posterolateral Approach ◽  
Malleolar Fractures

Open Reduction and Internal Fixation of Posterior Malleolus Fractures via a Posteromedial Approach

Orthopedics ◽  
2020 ◽  
Vol 43 (3) ◽  
pp. e166-e170
Author(s):  
Robert M. Zbeda ◽  
Steven Paul Friedel ◽  
Stuart D. Katchis ◽  
Lon Weiner
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Posterior Malleolus

scholarly journals Operative Treatment of Posterior Malleolar Fractures

2017 ◽  
Vol 11 (1) ◽  
pp. 732-742 ◽  
Author(s):  
Xiaojun Duan ◽  
Anish R. Kadakia
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Operative Treatment ◽  
Screw Fixation ◽  
Surgical Approaches ◽  
Indirect Reduction ◽  
Percutaneous Screw Fixation ◽  
Malleolar Fractures ◽  
Posterior Malleolus ◽  
Direct Exposure

Fractures of the posterior malleolus can occur in conjunction with fibular and medial malleolar fractures or in isolation. The indications for fixation of the posterior malleolus remain controversial except for the fragment sizes. A number of different surgical approaches and techniques for internal fixation of posterior malleolar fractures have been reported. Newer techniques such as direct exposure and plating of the posterior malleolus are chosen more frequently than traditional techniques of indirect reduction and percutaneous screw fixation. These attributes help to minimize the occurrence of postoperative complications.

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