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KMID : 0361620160510010077
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Journal of the Korean Orthopaedic Association
2016 Volume.51 No. 1 p.77 ~ p.84
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Features of Lateral Malleolar Fractures in Elderly Patients and Clinical Outcome of Locking Compression Plate Fixation
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황석민:Hwang Seok-Min
정홍근:Jung Hong-Geun/정형진:Chung Hyung-Jin/엄준상:Eom Joon-Sang/이동오:Lee Dong-Oh/조정현:Cho Jung-Hyun/박종태:Park Jong-Tae
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Abstract
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Purpose: Several studies have reported on the biomechanical advantages of a locking compression plate (LCP) for treatment of lateral malleolar fracture. However, few studies have reported clinical outcome after treatment of lateral malleolar fracture using a LCP in elderly patients. Thus, this study investigated the trends of lateral malleolar fractures in elderly patients and evaluated the clinical and radiological outcome of treating them using a 'locking compression distal fibula plate'.
Materials and Methods: Twenty-one patients (male: 3, female: 18) over 65 years old, who were followed-up for at least one year were enrolled in this study. They were treated surgically with open reduction and internal fixation using a LCP for lateral malleolar fracture from 2011 to 2014. Lauge-Hansen and Danis-Weber classification were used for preoperative classification of fractures. Visual analog scale (VAS) pain scores, the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scores, 4-graded subjective satisfaction and post-operative range of motion were used for the clinical evaluation. Time to bone union, non-union, mal-union, metal failure and implant loosening were assessed for radiographic outcomes.
Results: The mean age of patients was 71.2 years old, pain VAS and AOFAS score was 1.6 points and 94.2 points, respectively and 18 cases (85.7%) showed more than satisfaction in subjective satisfaction. Comminuted fracture was observed in 8 cases (38.1%) and lag screw insertion was performed in 7 ankles (33.3%). The mean bony union period was 3.6 months. There were 5 cases of mal-union, no case of non-union and metal failure.
Conclusion: Satisfaction level of elderly patients with lateral malleolar fracture was significantly associated with only pain at the final follow-up. Fixation with a LCP distal fibula plate can sometimes lead to metal irritation but largely resulted in good clinical outcome without serious complication.
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KEYWORD
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ankle, aged, lateral malleolus fracture, comminuted fractures, locking compression plate
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