Ankle joint re-balancing in the management of ankle fracture malunion using fibular lengthening: prospective clinical-radiological results at mid-term follow-up.
Arthritis
Articular re-balancing
Fibular lengthening
Malunion
Trauma
Journal
International orthopaedics
ISSN: 1432-5195
Titre abrégé: Int Orthop
Pays: Germany
ID NLM: 7705431
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
10
06
2020
accepted:
26
06
2020
pubmed:
10
7
2020
medline:
24
4
2021
entrez:
10
7
2020
Statut:
ppublish
Résumé
An unsatisfactory reduction and internal fixation of an ankle fracture can result in an alteration of the anatomical axes and distribution of the load on the ankle, with consequent development of chronic pain and articular degeneration. The aim of this study is to evaluate the results of the articular re-balancing with realignment and lengthening of the fibula in case of malunited distal fibular fractures. A review of prospectively collected data was performed for all patients with a diagnosis of malunion of the fibula and underwent ankle joint re-balancing with fibular lengthening. Twenty-three patients, with a mean age of 39.4 ± 13.1 years, have been evaluated using radiographic parameters, American Orthopaedic Foot and Ankle Surgeons ankle-hindfoot, Ankle Activity scale, and SF-36 score at six, 12, 24, and 36 months post-operatively. All cases treated showed at follow-up the osteotomy healed in good correction of the deformities. Clinical scores showed a clear improvement: final 36-month mean AOFAS was 74.0 ± 8.9 point, final 36-month mean HALASI score was 4.9 ± 0.9 points, 36-month follow-up SF-36 score showed an average score of 73.2 ± 10.7 points. Pre- and post-operative radiographic parameters have been registered and described. The ankle joint is a complex structure, and even minor changes of the structure of this joint can significantly compromise its functionality. Ankle joint re-balancing is an effective surgical procedure in case of fibular malunion. This procedure, in patients carefully selected, could procrastinate more disabling surgical procedure, as arthrodesis or prosthesis.
Identifiants
pubmed: 32642824
doi: 10.1007/s00264-020-04690-y
pii: 10.1007/s00264-020-04690-y
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
411-417Références
Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37(8):691–697. https://doi.org/10.1016/j.injury.2006.04.130
doi: 10.1016/j.injury.2006.04.130
pubmed: 16814787
Giannini S, Faldini C, Acri F, Leonetti D, Luciani D, Nanni M (2010) Surgical treatment of post-traumatic malalignment of the ankle. Injury 41(11):1208–1211. https://doi.org/10.1016/j.injury.2010.09.017
doi: 10.1016/j.injury.2010.09.017
pubmed: 20934697
Rockett MS, Ng A, Guimet M (2001) Posttraumatic ankle arthrosis. Clin Podiatr Med Surg 18(3):515–535
pubmed: 11499178
Tarr RR, Resnick CT, Wagner KS, Sarmiento A (1985) Changes in tibiotalar joint contact areas following experimentally induced tibial angular deformities. Clin Orthop Relat Res 199:72–80. https://doi.org/10.1097/00003086-198510000-00011
doi: 10.1097/00003086-198510000-00011
Ng A, Barnes ES (2009) Management of complications of open reduction and internal fixation of ankle fractures. Clin Podiatr Med Surg 26(1):105–125. https://doi.org/10.1016/j.cpm.2008.09.008
doi: 10.1016/j.cpm.2008.09.008
pubmed: 19121757
El-Rosasy M, Ali T (2013) Realignment-lengthening osteotomy for malunited distal fibular fracture. Int Orthop 37(7):1285–1290. https://doi.org/10.1007/s00264-013-1876-7
doi: 10.1007/s00264-013-1876-7
pubmed: 23568143
pmcid: 3685651
van Wensen RJ, van den Bekerom MP, Marti RK, van Heerwaarden RJ (2011) Reconstructive osteotomy of fibular malunion: review of the literature. Strategies Trauma Limb Reconstr 6(2):51–57. https://doi.org/10.1007/s11751-011-0107-2
doi: 10.1007/s11751-011-0107-2
pubmed: 21818702
pmcid: 3150649
Egger AC, Berkowitz MJ (2018) Operative treatment of the malunited fibula fracture. Foot Ankle Int. 39(10):1242–1252. https://doi.org/10.1177/1071100718795630
doi: 10.1177/1071100718795630
pubmed: 30165033
Ramsey PL, Hamilton W (1976) Changes in tibiotalar area of contact caused by lateral talar shift. J Bone Joint Surg Am 58(3):356–357. https://doi.org/10.2106/00004623-197658030-00010
doi: 10.2106/00004623-197658030-00010
pubmed: 1262367
Vrahas M, Fu F, Veenis B (1994) Intraarticular contact stresses with simulated ankle malunions. J Orthop Trauma 8(2):159–166. https://doi.org/10.1097/00005131-199404000-00014
doi: 10.1097/00005131-199404000-00014
pubmed: 8207574
Curtis MJ, Michelson JD, Urquhart MW, Byank RP, Jinnah RH (1992) Tibiotalar contact and fibular malunion in ankle fractures a cadaver study. Acta Orthop 63(3):326–329. https://doi.org/10.3109/17453679209154793
doi: 10.3109/17453679209154793
Thordarson DB, Motamed S, Hedman T, Ebramzadeh E, Bakshian S (1997) The effect of fibular malreduction on contact pressures in an ankle fracture malunion model. J Bone Joint Surg Am 79(12):1809–1815
doi: 10.2106/00004623-199712000-00006
Speed JS, Boyd HB (1936) Operative reconstruction of malunited fractures about the ankle joint. J Bone Joint Surg 18(2):270–286
Lui TH, Ip K, Chow HT (2005) Comparison of radiologic and arthroscopic diagnoses of distal tibiofibular syndesmosis disruption in acute ankle fracture. Arthroscopy 21(11):1370. https://doi.org/10.1016/j.arthro.2005.08.016
doi: 10.1016/j.arthro.2005.08.016
pubmed: 16325090
Yablon IG, Leach RE (1989) Reconstruction of malunited fractures of the lateral malleolus. J Bone Joint Surg Am 71(4):521–527. https://doi.org/10.2106/00004623-198971040-00007
doi: 10.2106/00004623-198971040-00007
pubmed: 2703512
Weber BG, Simpson LA (1985) Corrective lengthening osteotomy of the fibula. Clin Orthop Relat Res 199:61–67. https://doi.org/10.1097/00003086-198510000-00009
doi: 10.1097/00003086-198510000-00009
van Dijk CN, Verhagen RA, Tol JL (1997) Arthroscopy for problems after ankle fracture. J Bone Joint Surg Br 79:280–284
doi: 10.1302/0301-620X.79B2.0790280
Marti R, Raaymakers E, Nolte P (1990) Malunited ankle fractures. The late results of reconstruction. J Bone Joint Surg Br 72(4):709–713. https://doi.org/10.1302/0301-620x.72b4.2116416
doi: 10.1302/0301-620x.72b4.2116416
pubmed: 2116416
Eberl R, Kaminski A, Hauser J, Arens S, Nicolas V, Muhr G (2006) Oblique osteotomy for post-traumatic fibula incongruity. Chirurg. 77(5):439–446. https://doi.org/10.1007/s00104-005-1150-7
doi: 10.1007/s00104-005-1150-7
pubmed: 16479393
Henderson WB, Lau JTC (2007) Reconstruction of failed ankle fractures. Foot Ankle Clin 11(1):51–60. https://doi.org/10.1016/j.fcl.2005.12.006
doi: 10.1016/j.fcl.2005.12.006
Offierski CM, Graham JD, Hall JH, Harris WR, Schatzker JL (1982) Late revision of fibular malunion in ankle fractures. Clin Orthop Relat Res 171:145–149. 14
Rolfe B, Nordt W, Sallis JG, Distefano M (1989) Assessing fibular length using bimalleolar angular measurements. Foot Ankle Int 10(2):104–109. https://doi.org/10.1177/107110078901000210
doi: 10.1177/107110078901000210
Ebraheim NA, Elgafy H, Padanilam T (2003) Syndesmotic disruption in low fibular fractures associated with deltoid ligament injury. Clin Orthop Relat Res 409:260–267. https://doi.org/10.1097/01.blo.0000052935.71325.30
doi: 10.1097/01.blo.0000052935.71325.30
Michelson JD, Magid D, Ney DR, Fishman EK (1992) Examination of the pathologic anatomy of ankle fractures. J Trauma 32(1):65–70. https://doi.org/10.1097/00005373-199201000-00014
doi: 10.1097/00005373-199201000-00014
pubmed: 1732577
Thordarson DB (2004) Fusion in posttraumatic foot and ankle reconstruction. J Am Acad Orthop Surg 12(5):322–333. https://doi.org/10.5435/00124635-200409000-00007
doi: 10.5435/00124635-200409000-00007
pubmed: 15469227
Chou LB, Coughlin MT, Hansen S Jr, Haskell A, Lundeen G, Saltzman CL, Mann RA (2008) Osteoarthritis of the ankle: the role of arthroplasty. J Am Acad Orthop Surg 16(5):249–259. https://doi.org/10.5435/00124635-200805000-00003
doi: 10.5435/00124635-200805000-00003
pubmed: 18460685