Abstract
The objective was to evaluate the functional outcomes of anti-glide fixation by minimally invasive plate osteosynthesis (MIPPO) in lateral malleolus ankle fractures.The study was a retrospective cohort study conducted at a single trauma center. We reviewed 39 patients >60 years old with either isolated or non-isolated lateral malleolus Weber B ankle fractures.The main outcome measures were postoperative functional assessment performed with the American Orthopaedic Foot and Ankle Society (AOFAS) and Short Musculoskeletal Functional Assessment (SMFA) scores. Our results showed that the mean time to surgery was 1 day. Seventeen patients underwent surgery within 24 hours after sustaining the injury. The mean AOFAS and SMFA scores were 87.8 and 209.7, respectively. No patient developed implant failure or wound complications.It was concluded that the anti-glide plating of the lateral malleolus had better functional outcomes compared to lateral plating by open reduction and internal fixation (ORIF), as shown by the higher AOFAS scores and fewer postoperative complications.
Highlights
Ankle fractures are the third most common fracture in the elderly population, following hip and distal radius fractures [1]
A total of 106 patients who underwent anti-glide plate fixation of the lateral malleolus were included in this study; among them, 39 (36.8%) were >60 years old
Our study showed that anti-glide fixation of lateral malleolus fractures by MIPPO in the geriatric population was beneficial
Summary
Ankle fractures are the third most common fracture in the elderly population, following hip and distal radius fractures [1]. 100 to 200 ankle fractures per 100,000 individuals are reported [2-3], among this, 20% to 30% occur in the elderly [4]. Elderly and medically complex patients were treated conservatively. The increased morbidity with non-operative management has led to the development of operative techniques with ideal outcomes in elderly patients and those with significant comorbidities. Lateral malleolus fractures most commonly result from supination-external rotation injuries, in a common posterosuperior to inferoanterior direction. These are classified as Danis-Weber B fractures, which can be isolated or involve the medial malleolus. Fixation can be achieved in a variety of ways: direct open reduction and internal fixation with lag screw fixation and neutralization plating (lateral or posterolateral) or bridge plating (lateral or posterolateral), using a 1/3 tubular plate or precontoured locking plate, or intramedullary fixation with a screw or nail (i.e., Fibulock)
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