The Treatment of Danis-Weber Type B Fractures of the Distal Fibula by Multiple Kirschner Wires Fixation

2000 ◽  
Vol 13 (3) ◽  
pp. 529 ◽  
Author(s):  
Ho Yoon Kwak ◽  
Baik Young Song ◽  
Sang Wook Bae ◽  
Nam Hong Choi ◽  
Jin Young Kim
Keyword(s):  
Type B ◽  
Kirschner Wires ◽  
Distal Fibula ◽  
Weber Type

The Dorsal Antiglide Plate in the Treatment of Dank-Weber Type-B Fractures of the Distal Fibula

1990 ◽  
Vol &NA; (259) ◽  
pp. 204???209
Author(s):  
BENEDIKT WINKLER ◽  
BERNHARD G. WEBER ◽  
LEX A. SIMPSON
Keyword(s):  
Type B ◽  
Distal Fibula ◽  
Weber Type

scholarly journals Minimally Invasive Plate Osteosynthesis (MIPO) Versus Open Reduction and Internal Fixation (ORIF) in the Treatment of Distal Fibula Danis-Weber type B and C Fractures

2020 ◽  
Author(s):  
Cesare Marazzi ◽  
Matthias Wittauer ◽  
Michael T. Hirschmann ◽  
Enrique A. Testa
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Consecutive Series ◽  
Type B ◽  
Distal Fibula ◽  
Clear Space ◽  
Weber Type

Abstract BackgroundMinimally invasive plate-osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up.MethodsA consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analysed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n=35, MIPO n=35). Patients were assessed for postoperative pain using a visual analogue scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups; “no pain” for VAS=0, “low” for VAS=1-3, “moderate” for VAS=3-5 and “severe” for VAS=5-10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury as well as development of nonunion, were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap and talar tilt angle were evaluated postoperatively. ResultsThe overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p=0.029). Even though not statistically significant, specific surgery related complications such as skin necrosis (3% vs. 9%, p= 0.275), nonunion (0% vs. 6%, p=0.139), infections and wound healing disorders (9% vs. 20%, p=0.141) as well as postoperative pain (17% vs. 26%, p=0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3mm vs. 2.7mm, p=0.033). The talocrural angle, talar tilt angle, lateral and medial clear space showed to be equivalent in both groups.ConclusionIn this retrospective single-center consecutive series MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate. Trial registration:EKNZ Project-ID: 2019-02310; registrated 20th of December 2019 with swissethics

scholarly journals Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber type B and C fractures

2020 ◽  
Author(s):  
Cesare Marazzi ◽  
Matthias Wittauer ◽  
Michael T. Hirschmann ◽  
Enrique A. Testa
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Consecutive Series ◽  
Type B ◽  
Distal Fibula ◽  
Clear Space ◽  
Weber Type

Abstract Background Minimally invasive plate-osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up. Methods A consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analysed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n=35, MIPO n=35). Patients were assessed for postoperative pain using a visual analogue scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups; “no pain” for VAS=0, “low” for VAS=1-3, “moderate” for VAS=3-5 and “severe” for VAS=5-10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury as well as development of nonunion, were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap and talar tilt angle were evaluated postoperatively. Results The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p=0.029). Even though not statistically significant, specific surgery related complications such as skin necrosis (3% vs. 9%, p= 0.275), nonunion (0% vs. 6%, p=0.139), infections and wound healing disorders (9% vs. 20%, p=0.141) as well as postoperative pain (17% vs. 26%, p=0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3mm vs. 2.7mm, p=0.033). The talocrural angle, talar tilt angle, lateral and medial clear space showed to be equivalent in both groups. Conclusion In this retrospective single-center consecutive series MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate.

scholarly journals Minimally invasive plate osteosynthesis (MIPO) versus open reduction and internal fixation (ORIF) in the treatment of distal fibula Danis-Weber type B and C fractures

2020 ◽  
Author(s):  
Cesare Marazzi ◽  
Matthias Wittauer ◽  
Michael T. Hirschmann ◽  
Enrique A. Testa
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Consecutive Series ◽  
Type B ◽  
Distal Fibula ◽  
Clear Space ◽  
Weber Type

Abstract Background Minimally invasive plate-osteosynthesis (MIPO) has been reported to be superior to open reduction and internal fixation (ORIF) in the treatment of different long bone fractures. Nevertheless, in distal fibula fractures the evidence of MIPO remains scarce. The aim of this retrospective study was to compare the clinical and radiological outcomes of the minimally invasive techniques applied to the distal fibula with open reduction and internal fixation within a 12 months follow-up.Methods A consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 2010 and 2014 were retrospectively analysed. All distal fibular fractures requiring an operative treatment (Danis-Weber type B ≙ AO type 44 B1, 2, 3 and Danis-Weber type C ≙ AO type 44 C1, 2) were included (ORIF n=35, MIPO n=35). Patients were assessed for postoperative pain using a visual analogue scale (VAS) for pain (ranging from 0 to 10) and classified into 4 groups; “no pain” for VAS=0, “low” for VAS=1-3, “moderate” for VAS=3-5 and “severe” for VAS=5-10. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury as well as development of nonunion, were evaluated and analyzed. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap and talar tilt angle were evaluated postoperatively. Results The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. 37%, p=0.029). Even though not statistically significant, specific surgery related complications such as skin necrosis (3% vs. 9%, p= 0.275), nonunion (0% vs. 6%, p=0.139), infections and wound healing disorders (9% vs. 20%, p=0.141) as well as postoperative pain (17% vs. 26%, p=0.5) were found more frequently in the ORIF group. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3mm vs. 2.7mm, p=0.033). The talocrural angle, talar tilt angle, lateral and medial clear space showed to be equivalent in both groups.Conclusion In this retrospective single-center consecutive series MIPO was superior to ORIF in the surgical treatment of distal fibula fractures with respect to the overall complication rate.

scholarly journals Proximal Triplane Tibial Fracture in a 6-Year-Old Girl

2021 ◽  
Vol 3 (1) ◽  
pp. 38-40
Author(s):  
Ziyad AlShaqsi ◽  
Sara Alhabsi ◽  
Yumna Alnaabi ◽  
Yaqoub Almufargi
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Kirschner Wires ◽  
Distal Fibula ◽  
Distal Tibial Fractures ◽  
Proximal Tibial Fractures ◽  
Triplane Fracture ◽  
Salter Harris

Proximal tibial fractures are very rare. Our case is about a six-year-old girl presented with proximal tibial triplane fracture associated with proximal and distal fibula and distal tibial fractures, as a result of a fall of a cement wall on her right knee. A radiograph and computerized tomography (CT) scan were reported as Salter-Harris type III fracture. She was treated by an open reduction and internal fixation by a screw and Kirschner wires. She was followed up for 12 months and showed an excellent knee outcome and her knee range of motion was 10-130o. Anatomical reduction and stable fixation are necessary to prevent future pain, deformity and arthritis. The case demonstrates the efficacy of using an open reduction and internal fixation by a screw and Kirschner wires in treating children with triplane proximal tibial fracture.  This type of fracture is not frequently seen and a right diagnosis leads to better management, which could prevent future complications

scholarly journals Reporting Discrepancy Resolved by Findings and Time in 2947 Emergency Department Ankle X-rays

2019 ◽  
Vol 49 (4) ◽  
pp. 601-611 ◽  
Author(s):  
Thomas James York ◽  
P. J. Jenkins ◽  
A. J. Ireland
Keyword(s):  
Emergency Department ◽  
Working Hours ◽  
High Standard ◽  
Causative Factor ◽  
X Rays ◽  
Type B ◽  
Complete Dataset ◽  
Specific Finding ◽  
Weber Type ◽  
Major Discrepancy

Abstract Aims To identify common errors in ankle X-ray reporting between initial interpretation and final assessment at the virtual fracture clinic. Also, to assess time of initial reporting as a causative factor for discrepancy. Methods Two thousand nine hundred forty-seven final reports were reviewed by standard of agreement to the initial interpretation. Where discrepancy was found, it was classified and collated by specific finding. Comparison was made between reports with discrepancy and the complete dataset, allowing rates of error by finding to be established. The reports containing discrepancy were further classified by time period, this was compared against an expected value to establish if initial reporting outside of routine working hours was as accurate as that conducted within routine working hours. Results 94.4% of reports were in agreement with the initial interpretation, 2.9% contained minor discrepancy, and 2.7% major discrepancy. In 45.6% of reports there was no radiologically observable injury. 16.4% of reports contained a lateral malleolar fracture, most commonly Weber type B. 40.0% of all navicular fractures, and 33.3% of all cuboidal fractures were not commented upon in the initial reporting. Lower rates of more frequently observed findings were missed with 2.5% of Weber type B fractures not commented upon. An increased proportion of major discrepancy reports were generated from 00:00 to 07:59 (expected = 15.0%, observed = 22.2%; p = 0.07908). Similarly, a greater than expected number of minor discrepancy reports were found between 20:00 and 23:59 (expected = 18.0%, observed = 34.1%, p = 0.00025). Conclusions The initial reporting of ankle X-rays in the emergency department is performed to a high standard, however serious missed findings emphasise the need for timely senior review. Reporters should increase their awareness of navicular, cuboid, talar, and Weber A fractures which were missed at disproportionate rates. This study also finds evidence to support increased rates of error in initial reporting of ankle X-rays outside of normal working hours (17:00–07:59), particularly with a significantly increased rate of minor discrepancy seen from 20:00 to 23:59.

scholarly journals Diagnosis of tibiofibular syndesmosis instability in Weber type B malleolar fractures

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052093975
Author(s):  
Qiang Huang ◽  
Yongxing Cao ◽  
Chonglin Yang ◽  
Xingchen Li ◽  
Yangbo Xu ◽  
...  
Keyword(s):  
Ankle Fractures ◽  
Preoperative Imaging ◽  
Diagnostic Efficiency ◽  
Tibiofibular Syndesmosis ◽  
Type B ◽  
X Ray ◽  
Malleolar Fractures ◽  
Distal Tibiofibular Syndesmosis ◽  
Arthroscopic Findings ◽  
Weber Type

Objective This study was performed to analyze the clinical value of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations for the diagnosis of distal tibiofibular syndesmosis injuries in Weber type B ankle fractures with reference to the ankle arthroscopic findings. Methods This retrospective clinical study involved 52 patients with type B ankle fractures from August 2014 to January 2018. We analyzed the patients’ preoperative imaging data and judged the stability of the distal tibiofibular syndesmosis using X-ray, CT, and MRI examinations. We also evaluated the syndesmosis stability with arthroscopy both statically and dynamically. Results With the arthroscopic findings as the standard, the sensitivity of X-ray for diagnosing syndesmosis instability was 52.8%, the specificity was 100%, and the diagnostic efficiency was 67.3%. The sensitivity of CT for diagnosing syndesmosis instability was 77.8%, the specificity was 100%, and the diagnostic efficiency was 84.6%. The sensitivity of MRI for diagnosing syndesmosis instability was 100%, the specificity was 81.3%, and the diagnostic efficiency was 94.2%. Conclusion This study suggests that an arthroscopic examination may be recommended when the X-ray or CT features are different from the MRI findings while diagnosing tibiofibular syndesmosis instability in Weber type B malleolar fractures.

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