Safety of Posterolateral Approach in High-Risk Patients with Trimalleolar Fractures

Öz

Aim: Purpose of this study is to compare the outcomes of posterolateral approach (PLA) and minimal-invasive percutaneous anteroposterior (AP) approach for the fixation of posterior malleolar fragment in patients who have risk factors for wound healing. Material and Methods: 66 patients were analyzed in 2 study groups. Group 1: PLA (29 patients), Group 2: AP (37 patients). Patient demographics, risk factors for wound healing, presence of syndesmotic injury, fracture type, postoperative wound-healing complications and American Orthopedic Foot and Ankle Society ankle-hindfoot score (AOFAS) were recorded. Results: There was no difference between the study groups in regard to wound-healing problems. Obese and smokers had significantly more wound-healing problems regardless of the surgical approach. There was no statistically significant difference between the study groups in regard to AOFAS. Conclusion: In trimalleolar fractures, PLA can be safely considered even for the patients who have risk factors for wound-healing problems other than obesity and smoking.

Anahtar Kelimeler

• Posterolateral approach
• trimalleolar fracture
• high risk patients
• smoking
• obesity

Proje Numarası

KA20/269

Yüksek Risk Faktörlü Trimalleolar Kırık Hastalarında Posterolateral Yaklaşımın Güvenliği

Öz

Amaç: Bu çalışmanın amacı, yara iyileşmesi açısından risk faktörleri taşıyan hastalarda posterior malleol fragmanının tespitinde posterolateral yaklaşım (PLY) ve minimal invaziv perkütan anterior-posterior (AP) yaklaşımın sonuçlarını karşılaştırmaktır. Gereç ve Yöntemler: 66 hasta, 2 çalışma grubunda analiz edildi. Grup 1: PLY (29 hasta), Grup 2: AP (37 hasta). Hasta demografik özellikleri, yara iyileşmesi için risk faktörleri, sindezmotik yaralanma varlığı, kırık tipi, ameliyat sonrası yara iyileşmesi komplikasyonları ve Amerikan Ortopedik Ayak ve Ayak Bileği Derneği ayak bileği-arka ayak skoru (AOFAS) kaydedildi. Bulgular: Yara iyileşme sorunları açısından çalışma grupları arasında fark yoktu. Obez ve sigara içenlerin, cerrahi yaklaşımdan bağımsız olarak yara iyileşmesi sorunları anlamlı derecede daha fazlaydı. AOFAS açısından çalışma grupları arasında istatistiksel olarak anlamlı bir fark yoktu. Sonuçlar: Trimalleolar kırıklarda obezite ve sigara kullanımı dışında yara iyileşmesi sorunları açısından risk faktörleri olan hastalarda dahi PLA güvenle düşünülebilir.

Anahtar Kelimeler

• Posterolateral yaklaşım
• trimalleolar kırık
• yüksek riskli hasta
• sigara
• obezite

Destekleyen Kurum

Bu çalışma Başkent Üniversitesi Tıp ve Sağlık Bilimleri Araştırma Kurulu tarafından onaylanmış (Proje no: KA20/269) ve Başkent Üniversitesi Araştırma Fonunca desteklenmiştir.

Proje Numarası

KA20/269

Etik Beyan

Bu çalışmanın, özgün bir çalışma olduğunu; çalışmanın hazırlık, veri toplama, analiz ve bilgilerin sunumu olmak üzere tüm aşamalarından bilimsel etik ilke ve kurallarına uygun davrandığımı; bu çalışma kapsamında elde edilmeyen tüm veri ve bilgiler için kaynak gösterdiğimi ve bu kaynaklara kaynakçada yer verdiğimi; kullanılan verilerde herhangi bir değişiklik yapmadığımı, çalışmanın Committee on Publication Ethics (COPE)' in tüm şartlarını ve koşullarını kabul ederek etik görev ve sorumluluklara riayet ettiğimi beyan ederim. Herhangi bir zamanda, çalışmayla ilgili yaptığım bu beyana aykırı bir durumun saptanması durumunda, ortaya çıkacak tüm ahlaki ve hukuki sonuçlara razı olduğumu bildiririm.

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