当前位置： SCI文献检索 > ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY期刊下所有文献 > Leave it or fix it? How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures.

Leave it or fix it? How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures.

Abstract：

INTRODUCTION:This study investigated the effects of a small posterior malleolar fragment (PMF), containing less than 25% articular surface area, on ankle joint stability via computed tomography (CT) scanning under full weight bearing in a human cadaveric ankle fracture model. MATERIALS AND METHODS:A trimalleolar fracture with a PMF of less than 25% articular surface area was created in 6 pairs of fresh-frozen human cadaveric lower legs. The specimens were randomized into 2 groups stabilized by internal fixation including a positioning screw for syndesmotic reconstruction. In Group I the PMF was addressed by direct screw osteosynthesis, whereas in Group II the fragment was not fixed. Six predefined distances within the ankle were measured under axial loading. CT scans of each specimen were performed in intact and fixated states in neutral position, dorsiflexion and plantar-flexion of the ankle. RESULTS:In plantar-flexion, significant differences were detected between the groups with regard to rotational instability. Group II demonstrated a significantly increased inward rotation of the fibula compared with Group I. No significant differences were detected between the groups for each one of the measured distances in any of the three foot positions. CONCLUSIONS:Additional reduction and fixation of a small PMF seems to neutralize rotational forces in the ankle more effectively than a sole syndesmotic screw. Clinically, this becomes relevant in certain phases of the gait cycle. Direct screw osteosynthesis of a small PMF stabilizes the ankle more effectively than a positioning screw.

journal_name

Arch Orthop Trauma Surg

journal_title

Archives of orthopaedic and trauma surgery

authors

Evers J,Fischer M,Raschke M,Riesenbeck O,Milstrey A,Gehweiler D,Gueorguiev B,Ochman S

doi

10.1007/s00402-021-03772-9

subject

Has Abstract

pub_date

2021-01-28 00:00:00

eissn

0936-8051

issn

1434-3916

pii

10.1007/s00402-021-03772-9

pub_type

杂志文章

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