Comparison Of Two Different Plating Technique For Lateral Malleolar Fractures

Year 2018, Volume: 51 Issue: 1, 20 - 25, 30.03.2018

Kubilay Uğurcan Ceritoğlu , Hakan Yolaçan

Abstract

Aim: In
this study we aimed to compare functional and clinical results of two different
plate application technique by evaluating the results of patients whom were
treated with either posterolateral anti-glide plating or lateral neutralization
plating for Type B lateral malleolar fractures.

Material and Method: Thirty-seven
patients with Type B lateral malleolar fracture which were caused by supination-external
rotation injury that were treated with plate and screw fixation between November
2016 to June 2017 in our clinic were included in the study. Two different plating
technique were compared for functional and clinical results and complications.

Results: Twenty-one
(56.8%) patients were treated with lateral anatomical locking neutralization plate,
remaining 16 (43.2%) were treated with posterolateral tubular anti-glide plate.
All fractures were healed without any extra intervention. Twelfth month AOFAS
scores of (Group 2) patients in who were treated with anti-glide plate were higher
than others’ (P<0.01). There was no difference between groups in respect to
range of motion at 6^th month, preoperative and 12^th month
LEFS scores, AOFAS score at 3^rd and 6^th month and
complications (P>0.05). LEFS scores preoperatively and at 12^th
month were not different in groups (P=0.49, 0.56).

Conclusion: Both plating techniques
provide healing of lateral malleolar fractures that necessitates healing in
anatomical position with good clinical results. Posterolateral
anti-glide plating, with its unique advantages compared to the commonly used
lateral anatomical locking plating, is recommended as the primary method in the
surgery of Weber Type B lateral malleolar fractures with better functional
outcomes and low complication rates.

Keywords

anti-glide plate, lateral malleolar fracture, anatomical plate, neutralization plate

Lateral Malleol Kırıkları Tespitinde İki Farklı Plak Uygulama Yönteminin Karşılaştırılması

Abstract

Amaç: Bu
çalışmada lateral malleol Tip B kırığı posterolateralden anti-glide plaklama
tekniği veya lateralden nötralizasyon plağı tekniği ile tedavi edilen hastalar
değerlendirilerek iki yöntemin fonksiyonel ve klinik sonuçlarının
karşılaştırılması amaçlanmıştır.

Gereç ve Yöntemler: Kasım
2016 – Haziran 2017 tarihleri arasında supinasyon-eksternal rotasyon
yaralanması ile oluşan Weber Tip B lateral malleol kırıkları plak ve vida
tespiti ile tedavi edilen 37 hasta değerlendirildi. İki farklı plak uygulama
tekniği fonksiyonel skorlar, klinik sonuçlar ve komplikasyonlar açısından
kıyaslandı.

Bulgular:
Ortalama yaş 43,7 (19-69) idi. Hastaların 21 (%56,8)’inin cerrahisinde
lateralden anatomik kilitli plak kullanılırken; 16 (%43,2)’sının cerrahisinde
posterolateralden tübüler plak tercih edildi. Tüm hastaların kırıkları ek
müdahale gerekmeksizin kaynadı. Anti-glide plak tercih edilen Grup 2’deki
hastaların 12. aydaki AOFAS sonuçları istatistiksel olarak daha yüksekti
(P<0,01). Gruplar arasında 6. ayda iki ayak bileği eklem hareket açıklıkları
farkı, ameliyat öncesi ve 12. aydaki LEFS skoru, 3 ve 6. ay AOFAS skoru ve
komplikasyonlar yönünden istatistiksel olarak anlamlı fark yoktu (P>0,05).
Grupların kendi içinde ameliyat öncesi LEFS skoru ile 12. aydaki LEFS skoru
arasında istatistiksel olarak anlamlı fark yoktu (P=0,49, 0,56). Grup 1’deki
lateralden anatomik plak kullanılan hastalarda daha fazla vida kullanıldığı
görüldü (P<0,001).

Sonuç: Anatomik pozisyonda kaynamanın gerektiği lateral
malleol kırıklarının tedavisi için iki plak vida tespit yöntemi de iyi klinik
sonuçlarla iyileşme sağlamaktadır. Sıklıkla kullanılan lateralden anatomik
kilitli plakla tespit yöntemine göre kendine özgü avantajları olan
posterolateralden anti-glide plak tekniği düşük komplikasyon oranı ve daha iyi
fonksiyonel sonuçlar ile Weber Tip B lateral malleol kırıkları cerrahisinde
öncelikli tercih edilebilecek yöntem olduğunu düşünmekteyiz.

Keywords

Lateral malleol kırığı, anti-glide plak, anatomik plak, nötralizasyon plağı

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