Abstract
Objective This study is aimed at providing a nonbridging external fixation technique with pinning fixation for the pronation-abduction stage III ankle fracture. The secondary purpose was to evaluate its effect on anatomic reduction and fracture fragment stability against cadaveric models' rotation. Method A paired design study was conducted using 14 pairs of the cadaveric model which had been modeled for pronation-abduction stage III ankle fracture. One fracture model from each pair was randomly allocated to receive an open reduction and internal fixation, while the other was reduced and stabilized with the external fixation technique. After the surgery, the antirotational stability tests were performed with external rotation torques of 10 nm, 15 nm, and 20 nm applied, respectively. The postoperation reduction rate and ankle parameters were recorded in anteroposterior and lateral radiographs before and after the antirotational stability experiment. Result The outcomes were assessed according to Burwell-Charnley's radiographic criteria of reduction. It showed no statistically significant differences in reduction between the two groups (P < 0.05). The displacement of lateral fragment following a reduction in the external fixation group was significantly larger than that of the internal fixation group (3.14 ± 0.56 vs. 1.49 ± 0.39, P < 0.05). After applying rotational torques of 10 nm, 15 nm, and 20 nm, the results of other parameters showed no significant differences between the two groups. Conclusion This nonbridging external fixation method with pin fixation of fracture fragments might have the same effect as that of internal fixation on the reduction rate of pronation-abduction stage III ankle fracture.
Highlights
Ankle fracture is a common injury with an annual incidence of 71 to 169/100,000 (0.071%-0.169%) in recent years [1,2,3]
After applying rotational torques of 10 nm, 15 nm, and 20 nm in the External Fixation (EF) group, shown in Table 3, these parameters had no significant difference within the group
This study showed an innovative pin fixation and nonbridging external fixation technique and evaluated its reduction effectiveness in cadaveric PAB stage III fracture models
Summary
Ankle fracture is a common injury with an annual incidence of 71 to 169/100,000 (0.071%-0.169%) in recent years [1,2,3]. Open reduction and internal fixation (ORIF), advocated by AO/OTA, remained one of the primary treatments for this fracture, which had been widely accepted [7]. It could achieve anatomic reduction, stable immobilization, and early movement of ankle joints. Severe complications have been reported, including wound infection and even postoperative amputation and mortality in patients with diabetes mellitus [8, 9]. This modality is contraindicated when soft tissue is poor in many elderly patients [10]. External fixation has been suggested as an alternative minimally invasive technique for an ankle fracture
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
