Is the Addition of a Foot Ring to the Circular External Fixator Necessary in the Treatment of Extra-Articular Distal Tibia Fractures?

Abstract

The purpose of this study was to evaluate the effects of adding foot ring to circular external fixator (CEF) on the functional outcomes in the treatment of extra-articular distal tibia fractures. Retrospective comparative study. Level III. Fifty-six patients [CEF: 32 patients with an average follow-up of 65.03 months; circular external fixator with a foot ring (CEF-FR): 24 patients with an average follow-up of 93.04 months] who received treatment between December 1995 and September 2012 were retrospectively evaluated. We included the patients with extra-articular distal tibia fractures who were treated with CEF with or without foot ring. At the final follow-up visit, we evaluated our patients for AOFAS (American Orthopaedic Foot and Ankle Society) score, ankle dorsiflexion, ankle plantar flexion, inversion, eversion, and muscle strength. There were no statistical differences in the age, sex, and follow-up period of the 2 groups. The mean overall AOFAS score was 77.78 (47-100), and the mean AOFAS scores for the CEF-FR and CEF groups were 71.54 (47-88) and 82.47 (52-100), respectively. Significantly better results were observed in the CEF group (P = 0.03). The mean overall visual analog scale (VAS) score was 1.89 (0-4), and the visual analog scale (VAS) scores for the CEF-FR and CEF groups were 1.96 (0-4) and 1.72 (0-3), respectively. This difference was not statistically significant (P = 0.236). We conclude that CEF without the addition of a foot ring may result in better functional outcomes in the treatment of extra-articular distal tibia fractures. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.