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Intraoperative displacement may be avoided with fixation of the posterior malleolar fragment
Recently published results showed fixation of the posterior malleolar fragment prior to nailing of the tibia in patients with tibial shaft fractures may help avoid intraoperative displacement and poor reduction.
Researchers analyzed 1,113 tibial shaft fractures with posterior malleolar injuries and studied the cases regarding type of fracture, mechanism of injury, energy of injury, fracture characteristic and surgical characteristics. Researchers categorized patients into two groups: patients who had the posterior malleolus fixed before tibial nailing; and patients who had tibial nailing done before posterior malleolus fixation.
Of the 1,113 patients with nailed tibial shaft fractures, researchers found 96 had a concomitant posterior malleolus fracture. Of these, 73% were treated operatively. Results showed intraoperative displacement of the posterior malleolar fragment in 2% of patients in the malleolus-first group vs. 31% of patients in the tibia-first group. Researchers also noted 2% of patients in the malleolus-first group had poor reduction of the posterior malleolar fragment compared with 44% of patients in the tibia-first group. According to results, there was a statistically significant difference in the percentages of patients with poor quality of reduction. – by Casey Tingle
Disclosure: The researchers report no relevant financial disclosures.