Locking Plates for Distal Fibula Fractures in Young and Elderly Patients: A Retrospective Study

Overview

Journal World J Orthop

Publisher Baishideng Publishing Group

Specialty Orthopedics

Date 2023 Jul 24

PMID 37485428

Authors

Francesco Roberto Evola

Giovanni Francesco Di Fede

Giuseppe Evola

Martina Barchitta

Antonella Agodi

Gianfranco Longo

Affiliations

Soon will be listed here.

Abstract

Background: Ankle fractures are common injuries in the young and elderly populations. To prevent post-traumatic arthritis, an anatomic reconstruction of the ankle structure is mandatory. Open reduction and internal fixation is the treatment of choice among orthopaedics. Conventional plates allow stability of the fracture if bone quality is present. Locking plates might offer an advantage for the treatment of lateral malleolar fracture in patients with comminution, severe instability, distal fractures, or osteoporotic bone. Our hospital introduced a new locking plate for fracture of the distal fibula.

Aim: To evaluate locking plates in terms of outcomes and complications in young and elderly patients.

Methods: We retrospectively reviewed a total of 67 patients treated for displaced distal fibula fractures. Demographic data, number of comorbidities, use of inter fragmentary screw, complication, time of fracture healing, partial or full weight bearing, and reoperation were recorded for all patients. Clinical outcome was assessed by the American Orthopedic Foot and Ankle Society clinical scoring system. Radiographs were obtained at 4, 8, 12, 16, 20, and 24 wk until radiographic union was obtained.

Results: All patients displayed complete bony union on radiographic assessment, and no patients developed any serious complications. We observed two superficial infections, one delayed wound healing, and two plate intolerances. Significant differences were observed between the two age groups in terms of radiographic healing (11.9 wk in younger patients 13.7 wk in older patients; = 0.011) and in the American Orthopedic Foot and Ankle Society score at 6 mo after surgery (88.2 in younger patients 86.0 in older patients; = 0.001) and at 12 mo after surgery (92.6 in younger patients 90.0 in older patients; = 0.000).

Conclusion: Locking plates provide a stable and rigid fixation in multifragmentary and comminuted fractures or in the presence of poor bone quality.

Citing Articles

[Effectiveness comparison of a new hook-shaped anatomical locking plate and conventional anatomical locking plate in treatment of Danis-Weber type A lateral malleolus fractures].

Cui C, Fu B, Yang W, Liu Y, Zhu X Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2024; 38(4):438-443.

PMID: 38632063 PMC: 11024534. DOI: 10.7507/1002-1892.202312028.

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