THE EFFECT OF SCREW FIXATION AND BUTTRESS PLATE FIXATION ON CLINICAL AND RADIOLOGICAL RESULTS IN THE SURGICAL TREATMENT OF POSTERIOR MALLEOLAR FRACTURES

Yıl 2023, , 234 - 238, 24.10.2023

İbrahim Sungur , Kadri Encu , Mahmud Aydın , Serkan Sürücü , Sercan Çapkın

https://doi.org/10.26650/JARHS2023-1320786

Öz

Objective: Posterior malleolar fractures (PMF) are common among ankle fractures and their proper management is crucial to maintaining ankle stability. The purpose of this study was to compare the clinical and radiological effects of screw versus support plate fixation in the surgical treatment of PMF.
Material and Methods: Between December 2016 and February 2018, 82 patients who underwent surgical treatment for PMF were analyzed retrospectively. Patients were divided into two groups based on the type of fixation material used: screws and buttress plates. Using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, range of motion measurements, and radiographic evaluations, clinical evaluations were conducted.
Results: A total of 60 patients were included in the study, 33 of whom were treated with plate osteosynthesis and 27 with screw osteosynthesis. The demographic and clinical characteristics were similar between the groups. The AOFAS scores, range of motion measurements, and complication rates were comparable between the screw and plate fixation groups. The radiological evaluation showed no significant difference in posttraumatic arthritis levels between the two groups.
Conclusion: The screw fixation alone provides similar clinical andmradiological results compared to buttress plate fixation in the surgicaln treatment of PMF. These results are in advance of the growing evidence supporting screw-only osteosynthesis for Haraguchi type 1 and 2 posterior malleolus fractures.

Anahtar Kelimeler

Ankle fracture, bone screw, posterior malleolar fracture, surgical procedures

POSTERİOR MALLEOL KIRIKLARININ CERRAHİ TEDAVİSİNDE VİDA SABİTLEME VE DESTEK PLAKASI SABİTLEMESİNİN KLİNİK VE RADYOLOJİK SONUÇLAR ÜZERİNDEKİ ETKİSİ

Öz

Amaç: Posterior malleol kırıkları (PMF) ayak bileği kırıkları arasında yaygındır ve uygun tedavileri ayak bileği stabilitesini korumak için çok önemlidir. Bu çalışmanın amacı, PMF’nin cerrahi tedavisinde vida ile destek plağı tespitinin klinik ve radyolojik etkilerini karşılaştırmaktır.
Gereç ve Yöntemler: Aralık 2016 ile Şubat 2018 tarihleri arasında PMF nedeniyle cerrahi tedavi uygulanan 82 hasta retrospektif olarak analiz edildi. Hastalar kullanılan fiksasyon materyalinin türüne göre iki gruba ayrıldı: vidalar ve destek plakları. Amerikan Ortopedik Ayak ve Ayak Bileği Derneği (AOFAS) ayak bileği-arka ayak skoru, hareket açıklığı ölçümleri ve radyografik değerlendirmeler kullanılarak klinik değerlendirmeler yapıldı.
Bulgular: Çalışmaya 33’ü plak osteosentezi ve 27’si vida osteosentezi ile tedavi edilen toplam 60 hasta dâhil edildi. Demografik ve klinik özellikler gruplar arasında benzerdi. AOFAS skorları, hareket açıklığı ölçümleri ve komplikasyon oranları vida ve plak fiksasyon grupları arasında karşılaştırılabilirdi. Radyolojik değerlendirmede iki grup arasında posttravmatik artrit düzeyleri açısından anlamlı bir fark saptanmadı.
Sonuç: PMF’nin cerrahi tedavisinde tek başına vida tespiti, butress plak tespiti ile karşılaştırıldığında benzer klinik ve radyolojik sonuçlar sağlamaktadır. Bu sonuçlar, Haraguchi tip 1 ve 2 posterior malleol kırıkları için sadece vida osteosentezini destekleyen artan kanıtların ilerisindedir.

Anahtar Kelimeler

Ayak bileği kırığı, kortikal vida, posterior malleol kırığı, cerrahi prosedürler

Kaynakça

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