8/31/2023 0 Comments Cpt orif distal fibula fractureThe study was approved by the local ethical committee and conducted following the STROBE guidelines. This retrospective study was performed in a regional trauma hospital in Delémont, Switzerland. The purpose of this study was to create more evidence answering the question which operative technique is best in the largest retrospective cohort study. The hypothesis was that superior results might be achieved with MIPO regarding clinical and radiological outcomes as well as lower complication rates in comparison with ORIF. This retrospective study compares the clinical and radiological outcome and complications after MIPO to the traditional open reduction and internal fixation in the treatment of Danis-Weber types B and C fractures of the distal fibula (AO Type 44 B 1-2-3 and 44 C 1-2). Nevertheless, those studies could show a decreased risk for nonunion and infection when minimally invasive techniques where applied to treat distal fibula fractures. Of those studies, there is only one that directly compares MIPO to ORIF. ĭespite the increasing number of publications in the last 10 years investigating MIPO for femoral and tibial fractures, to date there is only a paucity of studies dealing with the treatment of distal fibula fractures using MIPO technique. Despite some drawbacks, such as the impossibility to manipulate and assess the fracture site under direct vision, current medical literature suggests that closed reduction and submuscular plating techniques through percutaneous insertion have comparable fracture healing rates and less percentages of non-union than ORIF. In the last decades, MIPO (minimally invasive plate osteosynthesis) techniques became widely successful with the launch of angular stable screw-plate systems like LISS (less invasive stabilization system) or LCP (locking compression plate), mainly to treat long bone fractures minimally invasively. The importance of respecting the biological status in the management of fractures is nowadays emphasized by a large number of publications investigating the possible harm of standard approaches on surrounding soft tissues. The ORIF of complex ankle fractures is a demanding procedure and associated with a considerable number of complications, mainly because of the thin soft tissue and skin layer covering the bone in this particular region. Trial registrationĮKNZ Project-ID: 2019-02310, registered on the 20th of December 2019 with swissethicsĪnkle injuries are among the most common traumatic pathologies treated in emergency departments worldwide, and lateral malleolus fractures represent one of the most common indications for open reduction and internal fixation (ORIF). 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. The talocrural angle, talar tilt angle, and lateral and medial clear space showed to be equivalent in both groups. The tibiofibular overlap demonstrated to be significantly lower in the ORIF group (3.3 mm vs. 26%, p = 0.5) were found more frequently in the ORIF group. 20%, p = 0.141), as well as postoperative pain (17% vs. 6%, p = 0.139), infections and wound healing disorders (9% vs. Even though not statistically significant, specific surgery-related complications such as skin necrosis (3% vs. The overall complication rate showed to be lower in the MIPO group compared to the ORIF group (14% vs. Radiologic outcome measures assessing the talocrural angle, lateral and medial clear space, tibiofibular overlap, and talar tilt angle were evaluated postoperatively. In addition, complications of postoperative fracture-related infection, wound healing disorders, vascular and nerve injury and development of nonunion were evaluated and analyzed. Patients were assessed for postoperative pain using a visual analog 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. 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). MethodsĪ consecutive series of patients who underwent surgery using either ORIF or MIPO for the treatment of distal fibula fractures between 20 were retrospectively analyzed. 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. Nevertheless, in distal fibula fractures, the evidence of MIPO remains scarce. 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.
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