CME OnDemand: 2022 AOFAS Annual Meeting-Quality of Reduction of Posterior Malleolar Fractures: A CT-Based Case-Control Study Comparing AP-PA Screw Fixation vs Posterolateral Approach

Quality of Reduction of Posterior Malleolar Fractures: A CT-Based Case-Control Study Comparing AP-PA Screw Fixation vs Posterolateral Approach

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Pdf Summary

This study compared the quality of reduction in posterior malleolar (PM) fractures treated with percutaneous anteroposterior (AP) or posteroanterior (PA) screw fixation versus a posterolateral (PL) approach. The aim was to determine whether there were differences in the postoperative reduction of these fractures.<br /><br />The study included 27 patients with PM fractures treated with AP-PA screw fixation and 27 patients treated with a PL approach. The average age of both groups was 44.4 years old, with a majority of female patients. The fractures were classified according to the Bartonicek and Rammelt classification.<br /><br />The results showed that there were no significant differences in the quality of reduction between the two groups. Both groups had similar outcomes in terms of tibiotalar and fibular notch reduction. The evaluation of reduction was performed using ankle CT images in the sagittal and axial planes.<br /><br />The study suggests that both AP-PA screw fixation and PL approach can lead to comparable outcomes in the reduction of PM fractures. However, further clinical prospective studies are needed to determine the clinical relevance of these results and to define the optimal strategy for fixation.<br /><br />In summary, this case-control study found no significant differences in the quality of reduction between PM fractures treated with AP-PA screw fixation and those treated with a PL approach. The study highlights the need for further research to confirm these findings and establish the best approach for managing these fractures.

Asset Subtitle

Maximiliano Hube, MD, Felipe Turner, Gonzalo F. Bastias, MD, Martin Contreras, Patricio A. Fuentes, Jose Ignacio Quezada Morales, MD

Keywords

study

quality of reduction

posterior malleolar fractures

percutaneous anteroposterior screw fixation

posteroanterior screw fixation

posterolateral approach

Bartonicek and Rammelt classification

tibiotalar reduction

fibular notch reduction

ankle CT images