The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

Tahta, Mesut; Firat, Ahmet; IŞIK, Çetin; Tecimel, Osman; akmeşe, ramazan; Bozkurt, Murat

The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

Çetin IŞIK, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Osman TECİMEL, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Ramazan AKMEŞE, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Ahmet FIRAT, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Mesut TAHTA, (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Murat BOZKURT (Ankara Atatürk Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, Ankara, Türkiye)

Acta Orthopaedica et Traumatologica Turcica

2 0

Yıl: 2013 Cilt: 47 Sayı: 1 Sayfa Aralığı: 27 - 31 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures

Öz:

Amaç: Çalışmada izole Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ile gergi bandı tekniklerinin klinik ve radyolojik sonuçlarının karşılaştırılması amaçlandı.Çalışma planı: Kasım 2005-Aralık 2010 tarihleri arasında, izole Danis- Weber tip A ve B lateral malleol kırığı tanısıyla 4 farklı merkez ve 6 ayrı klinikte opere olmuş 135 olgu (82 tip B, 53 tip A kırık) geriye dönük olarak değerlendirildi. Grup 1de yer alan 81 (55 tip B, 26 tip A) hastada lateralden 1/3 tübüler plak ve vida tekniği; Grup 2de yer alan 54 (27 tip B, 27 tip A) hastada ise gergi bandı tekniği ile cerrahi tespit uygulandı. Gruplar klinik ve radyolojik sonuçlarına göre karşılaştırıldı. İstatistiksel analizde Student-t testi kullanıldı.Bulgular: Grup 1de cerrahi insizyon skarı tip Ada ortalama 4.9 cm (4.5-5.4), tip Bde 6.8 cm (5.6-7.5) iken; Grup 2de 4 cm (3.5-5.2) ve 5.3 cm (5.0-5.9) olarak ölçüldü. Radyolojik kaynama Grup 1de ortalama 10 haftada (7-13) sağlanırken, Grup 2de 9 haftada (7-12) sağlandı. Grup 1de 12 hastada takiplerde implantlar çıkarılırken; Grup 2de sadece bir hastada implantların çıkarılmasına gerek görüldü. AOFAS Skoru grup 1de ortalama 90 (72-100) iken; Grup 2de 92 (70-100) olarak ölçüldü. Çıkarımlar: Danis-Weber Tip A ve B kırıklarında kullanılan her iki cerrahi teknik de, mükemmel sonuç vermektedir. Gergi bandı tekniği bu tip kırıklarda ucuz ve kabul edilebilir bir tedavi seçeneği olabilir.

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Ortopedi

Danis-Weber Tip A ve B lateral malleol kırıklarında plak-vida ve gergi bandı tekniği sonuçlarının karşılaştırılması

Öz:

Objective: The aim of this study was to compare the clinical and radiological results of plate-screw and tension band fixation in isolated Danis-Weber Type A and B lateral malleolar fractures. Methods: A total of 135 cases of lateral malleolar fractures (82 Danis-Weber Type B and 53 Type A) operated on in 4 different centers and 6 orthopaedic clinics between November 2005 and December 2010 were reviewed retrospectively. Eigthy-one patients (55 Type B and 26 Type A) had lateral 1/3 tubular plate and screw fixation (Group 1), while the remaining 54 patients (27 Type B and 27 Type A) were operated on with tension band technique (Group 2). The clinical and radiological results of the groups were compared. Student t test was used in statistical analysis. Results: The mean length of surgical incision scar was 4.9 cm (4.5-5.4 cm) for Type A fractures and 6.8 cm (5.6-7.5 cm) for Type B in Group 1 and 4.0 cm (3.5-5.2 cm) for Type A and 5.3 cm (5.0-5.9 cm) for Type B fractures in Group 2. Radiological union was obtained at mean of 10 weeks (7-13 weeks) in Group 1 and 9 weeks (7-12) in Group 2. The implant had to be removed in 12 patients in Group 1 and in one patient in Group 2. The mean AOFAS Score was 90 (72-100) and 92 (70-100) in Groups 1 and 2, respectively.Conclusion: Both plate-screw and tension band techniques revealed excellent results in isolated Danis-Weber Type A and B fractures. The tension band technique may be an alternative fixation method in the treatment of these fractures.

Anahtar Kelime:

Konular: Tıbbi Araştırmalar Deneysel Anestezi Ortopedi

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Bibliyografik

1. Ryd L, Bengtsson S. Isolated fracture of the lateral malleolus requires no treatment: 49 prospective cases of supination- eversion type 2 ankle fractures. Acta Orthop Scand 1992;63: 443-6.
2. Lindsjö U. Operative treatment of ankle fracture-disloca- tions. Clin Orthop 1985;199:28-38.
3. Brunner CF, Weber BG. Antiglade plate with supplementary compression. In: Brunner CF, Weber BG, editors. Special Techniques in internal fixation. New York: Springer-Verlag; 1982. p. 123-33.
4. Ostrum RF, Litsky AS. Tension band fixation of medial malleolus fractures. J Orthop Trauma 1992;6:464-8. 5. Kanakis TE, Papadakis E, Orfanos A, Andreadakis A, Xylouris E. Figure eight tension band in the treatment of fractures and pseudarthroses of the medial malleolus. Injury 1990;21:393-7.
6. Mak KH, Chan KM. Leung PC, Ankla fracture treated with the AO principle-an experience with 116 cases. Injury 1985;16: 265-72.
7. DeSouza LJ, Gustilo RB, Meyer TJ. Results of operative treatment of displaced external rotation-abduction fractures of the ankle. J Bone Joint Surg Am 1985;67:1066-74.
8. Winkler B, Weber BG, Simpson LA. The dorsal antiglide plate in the treatment of Danis-Weber Type-B fractures of the distal fibula. Clin Orthop Relat Res 1990;(259):204-9.
9. Panchbhavi VK, Vallurupalli S, Morris R. Comparison of augmentation methods for internal fixation of osteoporotic ankle fractures. Foot Ankle Int 2009;30:696-703.
10. Mast J, Jakob R, Ganz R. Planning and reduction techniques in fracture surgery. New York: Springer-Verlag; 1989. p. 735-62.
11. Eckerwall G, Persson BM. Fracture of lateral malleolus. Comparison of 2 fixation methods in cadavers. Acta Orthop Scand 1993;64:595-7.
12. Schaffer JJ, Manoli A. The Antiglade plate for distal fibular fixation. A biomechanical comparison with fixation with a lateral plate. J Bone Joint Surg 1987;69:596-604.
13. Kim HJ, Oh JK, Oh CW, Hwang JH, Biswal S. Anterior transposition of the superficial peroneal nevre branch during the internal fixation of the lateral malleolus. J Orthop Trauma 2010;68:421-4.
14. Olcay E, Ozturk A, Aksoy B, Ari Z, Bulbul M, Sahinoglu K. Surgical anatomy and safe zones of the superficial peroneal branch of the peroneal nerve in the ankle. [Article in Turkish] Acta Orthop Traumatol Turc 1998;32:340-3.
15. Mirza A, Moriarty AM, Probe RA, Ellis TJ. Percutaneous plating of the distal tibia and fibula: Risk of injury to the saphenous and superficial peroneal nerves. J Orthop Trauma 2010:24:495-8.

APA	IŞIK Ç, Tecimel O, akmeşe r, Firat A, Tahta M, Bozkurt M (2013). The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. , 27 - 31.
Chicago	IŞIK Çetin,Tecimel Osman,akmeşe ramazan,Firat Ahmet,Tahta Mesut,Bozkurt Murat The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. (2013): 27 - 31.
MLA	IŞIK Çetin,Tecimel Osman,akmeşe ramazan,Firat Ahmet,Tahta Mesut,Bozkurt Murat The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. , 2013, ss.27 - 31.
AMA	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. . 2013; 27 - 31.
Vancouver	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. . 2013; 27 - 31.
IEEE	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M "The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures." , ss.27 - 31, 2013.
ISNAD	IŞIK, Çetin vd. "The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures". (2013), 27-31.

APA	IŞIK Ç, Tecimel O, akmeşe r, Firat A, Tahta M, Bozkurt M (2013). The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthopaedica et Traumatologica Turcica, 47(1), 27 - 31.
Chicago	IŞIK Çetin,Tecimel Osman,akmeşe ramazan,Firat Ahmet,Tahta Mesut,Bozkurt Murat The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthopaedica et Traumatologica Turcica 47, no.1 (2013): 27 - 31.
MLA	IŞIK Çetin,Tecimel Osman,akmeşe ramazan,Firat Ahmet,Tahta Mesut,Bozkurt Murat The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthopaedica et Traumatologica Turcica, vol.47, no.1, 2013, ss.27 - 31.
AMA	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthopaedica et Traumatologica Turcica. 2013; 47(1): 27 - 31.
Vancouver	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthopaedica et Traumatologica Turcica. 2013; 47(1): 27 - 31.
IEEE	IŞIK Ç,Tecimel O,akmeşe r,Firat A,Tahta M,Bozkurt M "The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures." Acta Orthopaedica et Traumatologica Turcica, 47, ss.27 - 31, 2013.
ISNAD	IŞIK, Çetin vd. "The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures". Acta Orthopaedica et Traumatologica Turcica 47/1 (2013), 27-31.