Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study
Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise. We retrospectively reviewed the results of fluoroscopy-guided red...
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| Veröffentlicht in: | The bone & joint journal 2016-09, Vol.98-B (9), p.1197-1201 |
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| container_title | The bone & joint journal |
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| creator | Ashman, B D Kong, C Wing, K J Penner, M J Bugler, K E White, T O Younger, A S E |
| description | Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise.
We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined.
Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7).
Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201. |
| doi_str_mv | 10.1302/0301-620X.98B9.37140 |
| format | Article |
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We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined.
Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7).
Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201.</description><identifier>ISSN: 2049-4394</identifier><identifier>EISSN: 2049-4408</identifier><identifier>DOI: 10.1302/0301-620X.98B9.37140</identifier><identifier>PMID: 27587520</identifier><language>eng</language><publisher>England</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Ankle Fractures - diagnosis ; Ankle Fractures - etiology ; Ankle Fractures - surgery ; Bone Nails ; Cohort Studies ; Confidence Intervals ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diagnosis ; Female ; Fibula - injuries ; Fibula - surgery ; Fluoroscopy ; Follow-Up Studies ; Fracture Fixation, Internal - instrumentation ; Fracture Fixation, Internal - methods ; Fracture Healing - physiology ; Humans ; Joint Instability - surgery ; Male ; Middle Aged ; Range of Motion, Articular - physiology ; Retrospective Studies ; Risk Assessment ; Treatment Outcome</subject><ispartof>The bone & joint journal, 2016-09, Vol.98-B (9), p.1197-1201</ispartof><rights>2016 The British Editorial Society of Bone & Joint Surgery.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-3b286c4b47e65d63ac4a52ad98166aec518b78641c8d0e45842c500a9776fef43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27587520$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ashman, B D</creatorcontrib><creatorcontrib>Kong, C</creatorcontrib><creatorcontrib>Wing, K J</creatorcontrib><creatorcontrib>Penner, M J</creatorcontrib><creatorcontrib>Bugler, K E</creatorcontrib><creatorcontrib>White, T O</creatorcontrib><creatorcontrib>Younger, A S E</creatorcontrib><title>Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study</title><title>The bone & joint journal</title><addtitle>Bone Joint J</addtitle><description>Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise.
We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined.
Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7).
Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Ankle Fractures - diagnosis</subject><subject>Ankle Fractures - etiology</subject><subject>Ankle Fractures - surgery</subject><subject>Bone Nails</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Female</subject><subject>Fibula - injuries</subject><subject>Fibula - surgery</subject><subject>Fluoroscopy</subject><subject>Follow-Up Studies</subject><subject>Fracture Fixation, Internal - instrumentation</subject><subject>Fracture Fixation, Internal - methods</subject><subject>Fracture Healing - physiology</subject><subject>Humans</subject><subject>Joint Instability - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Range of Motion, Articular - physiology</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Treatment Outcome</subject><issn>2049-4394</issn><issn>2049-4408</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kctu1TAQhi0EotWhb4CQl2xyaseO47CDilKkSmxAYmdN7ElryImDL4XzGLwxTi94MR5r_pnfmo-Q15ztuWDtOROMN6pl3_eD_jDsRc8le0ZOWyaHRkqmnz_lYpAn5CylH6wezTiX_CU5aftO913LTsnfy7mEGJIN67G5Kd6hoxFdsdmHhcLi6OTHMkOkC_i5Pv7AfSUHeoAFbpCWJWUYZ6zinzVOEWwuERP1C12rGJec6G-fb6nzMGLG9I5C9cjVdcXqc4fUhtsQM025uOMr8mKCOeHZ470j3y4_fr24aq6_fPp88f66sW2nciPGVisrR9mj6pwSYCV0LbhBc6UAbcf12GsludWOoey0bG3HGAx9ryacpNiRtw9z1xh-FUzZHHyyOM-wYCjJ8G2QEKyGHZEPUlv_nCJOZo3-APFoODMbD7PxMBsPs_Ew9zxq25tHhzIe0P1vetq--Ac8m4kA</recordid><startdate>201609</startdate><enddate>201609</enddate><creator>Ashman, B D</creator><creator>Kong, C</creator><creator>Wing, K J</creator><creator>Penner, M J</creator><creator>Bugler, K E</creator><creator>White, T O</creator><creator>Younger, A S E</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201609</creationdate><title>Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study</title><author>Ashman, B D ; Kong, C ; Wing, K J ; Penner, M J ; Bugler, K E ; White, T O ; Younger, A S E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-3b286c4b47e65d63ac4a52ad98166aec518b78641c8d0e45842c500a9776fef43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Ankle Fractures - diagnosis</topic><topic>Ankle Fractures - etiology</topic><topic>Ankle Fractures - surgery</topic><topic>Bone Nails</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Female</topic><topic>Fibula - injuries</topic><topic>Fibula - surgery</topic><topic>Fluoroscopy</topic><topic>Follow-Up Studies</topic><topic>Fracture Fixation, Internal - instrumentation</topic><topic>Fracture Fixation, Internal - methods</topic><topic>Fracture Healing - physiology</topic><topic>Humans</topic><topic>Joint Instability - surgery</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Range of Motion, Articular - physiology</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ashman, B D</creatorcontrib><creatorcontrib>Kong, C</creatorcontrib><creatorcontrib>Wing, K J</creatorcontrib><creatorcontrib>Penner, M J</creatorcontrib><creatorcontrib>Bugler, K E</creatorcontrib><creatorcontrib>White, T O</creatorcontrib><creatorcontrib>Younger, A S E</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The bone & joint journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ashman, B D</au><au>Kong, C</au><au>Wing, K J</au><au>Penner, M J</au><au>Bugler, K E</au><au>White, T O</au><au>Younger, A S E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study</atitle><jtitle>The bone & joint journal</jtitle><addtitle>Bone Joint J</addtitle><date>2016-09</date><risdate>2016</risdate><volume>98-B</volume><issue>9</issue><spage>1197</spage><epage>1201</epage><pages>1197-1201</pages><issn>2049-4394</issn><eissn>2049-4408</eissn><abstract>Patients with diabetes are at increased risk of wound complications after open reduction and internal fixation of unstable ankle fractures. A fibular nail avoids large surgical incisions and allows anatomical reduction of the mortise.
We retrospectively reviewed the results of fluoroscopy-guided reduction and percutaneous fibular nail fixation for unstable Weber type B or C fractures in 24 adult patients with type 1 or type 2 diabetes. The re-operation rate for wound dehiscence or other indications such as amputation, mortality and functional outcomes was determined.
Two patients developed lateral side wound infection, one of whom underwent wound debridement. Three other patients required re-operation for removal of symptomatic hardware. No patient required a below-knee amputation. Six patients died during the study period for unrelated reasons. At a median follow-up of 12 months (7 to 38) the mean Short Form-36 Mental Component Score and Physical Component Score were 53.2 (95% confidence intervals (CI) 48.1 to 58.4) and 39.3 (95% CI 32.1 to 46.4), respectively. The mean Visual Analogue Score for pain was 3.1 (95% 1.4 to 4.9). The mean Ankle Osteoarthritis Scale total score was 32.9 (95% CI 16.0 to 49.7).
Fluoroscopy-guided reduction and fibular nail fixation of unstable ankle fractures in patients with diabetes was associated with a low incidence of wound and overall complications, while providing effective surgical fixation. Cite this article: Bone Joint J 2016;98-B:1197-1201.</abstract><cop>England</cop><pmid>27587520</pmid><doi>10.1302/0301-620X.98B9.37140</doi><tpages>5</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Ankle Fractures - diagnosis Ankle Fractures - etiology Ankle Fractures - surgery Bone Nails Cohort Studies Confidence Intervals Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Female Fibula - injuries Fibula - surgery Fluoroscopy Follow-Up Studies Fracture Fixation, Internal - instrumentation Fracture Fixation, Internal - methods Fracture Healing - physiology Humans Joint Instability - surgery Male Middle Aged Range of Motion, Articular - physiology Retrospective Studies Risk Assessment Treatment Outcome |
| title | Fluoroscopy-guided reduction and fibular nail fixation to manage unstable ankle fractures in patients with diabetes: a retrospective cohort study |
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