Does routinely repairing deltoid ligament injuries in type B ankle joint fractures influence long term outcomes?

Introduction. Ankle joint fractures are one of the most common injuries dealt with by orthopedic surgeons. Objective. To determine to what extent do diagnostics, estimation and choice of treatment of tibiofibular syndesmosis injuries affect the final clinical result. Patients and Methods. The study represents retrospective-prospective analysis of the data obtained from 102 patients treated for ankle injury due to malleolar ankle joint fractures and tibiofibular syndesmosis at the Clinic of Traumatology. The average value of monitoring was 61.62 months. According to the Danis-Weber classification, C1 fracture was present in 77 respondents (75.49%); C2 in 23 (22.5%); and C3 fracture in 2 respondents (1.96%). The Danis-Weber classification was used in this paper and hence we divided 102 patients with type C fractures according to the above mentioned classification. The first group (G1) was consisted of 48 (47%) patients who had undergone the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The second group (G2) was consisted of 54 (53%) patients who did not require the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The syndesmotic screw was placed in cases of: supra-syndesmotic fractures of the fibula associated with rupture of the deltoid ligament and fracture types according to the Topliss A and B. Three, six and twelve months after the surgery, the clinical results were examined using the American Orthopaedic Foot and Ankle Society scoring scale. Discussion. All acute unstable injuries should be treated surgically, which includes the deltoid ligament repair, open reduction and internal fixation of the injured syndesmosis. This is considered to be the best way to avoid unwanted complications. Conclusion. There was no significant difference in the final results of treatment between patients from the group G1, where the syndesmotic screw fixation was performed, and patients from the group G2, where the syndesmotic screw fixation was not performed.

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Poor Long-Term Outcomes for Type B Aortic Dissections Raises the Need for Re-Evaluating Current Management Strategies: A Population-Based Analysis

Journal of Vascular Surgery ◽

10.1016/j.jvs.2015.08.038 ◽

2015 ◽

Vol 62 (5) ◽

pp. 1381

Author(s):

Husain Khambati ◽

Prasad Jetty

Keyword(s):

Management Strategies ◽

Population Based ◽

Type B ◽

Long Term Outcomes ◽

Current Management ◽

Aortic Dissections

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Early and Long-Term Follow-Up for Chronic Type B and Type Non-A Non-B Aortic Dissection Using the Frozen Elephant Trunk Technique

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.714638 ◽

2021 ◽

Vol 8 ◽

Author(s):

Congcong Luo ◽

Ruidong Qi ◽

Yongliang Zhong ◽

Suwei Chen ◽

Hao Liu ◽

...

Keyword(s):

Overall Survival ◽

Aortic Dissection ◽

Type B ◽

Frozen Elephant Trunk ◽

Long Term Outcomes ◽

Chronic Type ◽

Elephant Trunk ◽

Long Term Follow Up

Background: This study aimed to evaluate the early and long-term outcomes of a single center using a frozen elephant trunk (FET) procedure for chronic type B or non-A non-B aortic dissection.Methods: From February 2009 to December 2019, 79 patients diagnosed with chronic type B or non-A non-B aortic dissection who underwent the FET procedure were included in the present study. We analyzed operation mortality and early and long-term outcomes, including complications, survival and interventions.Results: The operation mortality rate was 5.1% (4/79). Spinal cord injury occurred in 3.8% (3/79), stroke in 2.5% (2/79), and acute renal failure in 5.1% (4/79). The median follow-up time was 53 months. The overall survival rates were 96.2, 92.3, 88.0, 79.8, and 76.2% at 1/2, 1, 3, 5 and 7 years, respectively. Moreover, 79.3% of patients did not require distal aortic reintervention at 7 years. The overall survival in the subacute group was superior to that in the chronic group (P = 0.047).Conclusion: The FET technique is a safe and feasible approach for treating chronic type B and non-A non-B aortic dissection in patients who have contraindications for primary endovascular aortic repair. The technique combines the advantages of both open surgical repair and endovascular intervention, providing comparable early and long-term follow-up outcomes and freedom from reintervention.

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