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1000 Titel
  • Leave it or fix it? How fixation of a small posterior malleolar fragment neutralizes rotational forces in trimalleolar fractures
1000 Autor/in
  1. Evers, Julia |
  2. Fischer, Maren |
  3. Raschke, Michael |
  4. Riesenbeck, Oliver |
  5. Milstrey, Alexander |
  6. Gehweiler, Dominic |
  7. Gueorguiev, Boyko |
  8. Ochman, Sabine |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-01-28
1000 Erschienen in
1000 Quellenangabe
  • 142(6):1031-1037
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00402-021-03772-9 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9110545/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Introduction!#!This study investigated the effects of a small posterior malleolar fragment (PMF), containing less than 25% articular surface area, on ankle joint stability via computed tomography (CT) scanning under full weight bearing in a human cadaveric ankle fracture model.!##!Materials and methods!#!A trimalleolar fracture with a PMF of less than 25% articular surface area was created in 6 pairs of fresh-frozen human cadaveric lower legs. The specimens were randomized into 2 groups stabilized by internal fixation including a positioning screw for syndesmotic reconstruction. In Group I the PMF was addressed by direct screw osteosynthesis, whereas in Group II the fragment was not fixed. Six predefined distances within the ankle were measured under axial loading. CT scans of each specimen were performed in intact and fixated states in neutral position, dorsiflexion and plantar-flexion of the ankle.!##!Results!#!In plantar-flexion, significant differences were detected between the groups with regard to rotational instability. Group II demonstrated a significantly increased inward rotation of the fibula compared with Group I. No significant differences were detected between the groups for each one of the measured distances in any of the three foot positions.!##!Conclusions!#!Additional reduction and fixation of a small PMF seems to neutralize rotational forces in the ankle more effectively than a sole syndesmotic screw. Clinically, this becomes relevant in certain phases of the gait cycle. Direct screw osteosynthesis of a small PMF stabilizes the ankle more effectively than a positioning screw.
1000 Sacherschließung
lokal Ankle Joint/surgery [MeSH]
lokal Computed tomography
lokal Trauma Surgery
lokal Humans [MeSH]
lokal Ankle Fractures/diagnostic imaging [MeSH]
lokal Posterior malleolar fragment
lokal Treatment Outcome [MeSH]
lokal Retrospective Studies [MeSH]
lokal Bone Screws [MeSH]
lokal Osteosynthesis
lokal Trimalleolar fracture
lokal Ankle
lokal Cadaver [MeSH]
lokal Fracture Fixation, Internal/methods [MeSH]
lokal Ankle Fractures/surgery [MeSH]
lokal Fracture
lokal Positioning screw
1000 Liste der Beteiligten
  1. https://orcid.org/0000-0002-0571-3611|https://frl.publisso.de/adhoc/uri/RmlzY2hlciwgTWFyZW4=|https://frl.publisso.de/adhoc/uri/UmFzY2hrZSwgTWljaGFlbA==|https://frl.publisso.de/adhoc/uri/Umllc2VuYmVjaywgT2xpdmVy|https://frl.publisso.de/adhoc/uri/TWlsc3RyZXksIEFsZXhhbmRlcg==|https://frl.publisso.de/adhoc/uri/R2Vod2VpbGVyLCBEb21pbmlj|https://frl.publisso.de/adhoc/uri/R3Vlb3JndWlldiwgQm95a28=|https://frl.publisso.de/adhoc/uri/T2NobWFuLCBTYWJpbmU=
1000 Hinweis
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1000 Erstellt am 2023-04-28T16:04:12.032+0200
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1000 Zuletzt bearbeitet Fri Oct 20 20:40:28 CEST 2023
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