DISTAL THIRD TIBIAL FRACTURE SURGERY WITH FIBULAR FIXATION: IS IT NECESSARY FOR UNION AND ALIGNMENT?

Necmettin Turgut; Ahmet İnce; Meric Unal

Makale detayları

DISTAL THIRD TIBIAL FRACTURE SURGERY WITH FIBULAR FIXATION: IS IT NECESSARY FOR UNION AND ALIGNMENT?

Yazarlar:

Necmettin Turgut | Ahmet İnce | Meric Unal

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Surgery

Dergi:

Medical Journal of Süleyman Demirel University Vol.30 Issue 3, pp.308-315

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001299105

pISSN:

1300-7416

Anahtar kelimeler:

Özet:

 Objective The management of distal third tibial fractures remain controversial. The aim of the present study was to evaluate whether concurrent fibular fixation changes union rates and aids in alignment in the case of distal third tibia fractures. Material and Method The study included 106 distal third tibia fracture operation cases in which the distance from the fracture to the plafond was between 3-12 cm at a single centre between January 2016 and June 2020. The patients were divided into three groups according to the status of the fibula: Group 1 without fibular fixation with the presence of a fibula fracture, 47 cases, Group 2 concurrent fibular fixation with the presence of a fibular fracture, 38 cases and Group 3 intact fibula, 21 cases. All fibular fixation surgeries were performed with locked plates LCP and tibial fixation with either LCP or intramedullary nailing IMN. The primary outcome measures were union and alignment. Age, gender, AO classification, fibula fracture location, presence of an open fracture, implant type and time delay for surgery were also assessed. Results None of the variables except the presence of an open fracture was significant for the union rates or alignment. The union rate was significantly less if there was an open fracture in the concurrent fibular fixation group p0.001. Closed fractures were associated with better union rates according to the logistic regression analysis OR5,00 95 CI 2,24-11,48. Conclusion The present study suggests that a concurrent fibular fixation in the case of distal third tibia fractures improves neither the union rates nor the alignment. Therefore, we conclude that a fibular fixation is not a necessity in achieving better results and should not be performed in case of an open fracture considering the lesser union rate and the burden involved with an additional surgery.

 Objective The management of distal third tibial fractures remain controversial. The aim of the present study was to evaluate whether concurrent fibular fixation changes union rates and aids in alignment in the case of distal third tibia fractures. Material and Method The study included 106 distal third tibia fracture operation cases in which the distance from the fracture to the plafond was between 3-12 cm at a single centre between January 2016 and June 2020. The patients were divided into three groups according to the status of the fibula: Group 1 without fibular fixation with the presence of a fibula fracture, 47 cases, Group 2 concurrent fibular fixation with the presence of a fibular fracture, 38 cases and Group 3 intact fibula, 21 cases. All fibular fixation surgeries were performed with locked plates LCP and tibial fixation with either LCP or intramedullary nailing IMN. The primary outcome measures were union and alignment. Age, gender, AO classification, fibula fracture location, presence of an open fracture, implant type and time delay for surgery were also assessed. Results None of the variables except the presence of an open fracture was significant for the union rates or alignment. The union rate was significantly less if there was an open fracture in the concurrent fibular fixation group p0.001. Closed fractures were associated with better union rates according to the logistic regression analysis OR5,00 95 CI 2,24-11,48. Conclusion The present study suggests that a concurrent fibular fixation in the case of distal third tibia fractures improves neither the union rates nor the alignment. Therefore, we conclude that a fibular fixation is not a necessity in achieving better results and should not be performed in case of an open fracture considering the lesser union rate and the burden involved with an additional surgery.

 Objective The management of distal third tibial fractures remain controversial. The aim of the present study was to evaluate whether concurrent fibular fixation changes union rates and aids in alignment in the case of distal third tibia fractures. Material and Method The study included 106 distal third tibia fracture operation cases in which the distance from the fracture to the plafond was between 3-12 cm at a single centre between January 2016 and June 2020. The patients were divided into three groups according to the status of the fibula: Group 1 without fibular fixation with the presence of a fibula fracture, 47 cases, Group 2 concurrent fibular fixation with the presence of a fibular fracture, 38 cases and Group 3 intact fibula, 21 cases. All fibular fixation surgeries were performed with locked plates LCP and tibial fixation with either LCP or intramedullary nailing IMN. The primary outcome measures were union and alignment. Age, gender, AO classification, fibula fracture location, presence of an open fracture, implant type and time delay for surgery were also assessed. Results None of the variables except the presence of an open fracture was significant for the union rates or alignment. The union rate was significantly less if there was an open fracture in the concurrent fibular fixation group p0.001. Closed fractures were associated with better union rates according to the logistic regression analysis OR5,00 95 CI 2,24-11,48. Conclusion The present study suggests that a concurrent fibular fixation in the case of distal third tibia fractures improves neither the union rates nor the alignment. Therefore, we conclude that a fibular fixation is not a necessity in achieving better results and should not be performed in case of an open fracture considering the lesser union rate and the burden involved with an additional surgery.

 Amaç Distal 13 tibia kırıklarının tedavi yönetimi tartışmalıdır. Bu çalışmanın amacı aynı zamanda yapılan fibular fiksasyonun kaynama oranlarını arttırıp arttırmadığını ve dizilim açısından gerekliliğini değerlendirmektir. Gereç ve Yöntem Bu çalışmaya distal 13 tibia kırığı nedeniyle tek bir merkezde Ocak 2016 ile Haziran 2020 arasında opere edilmiş 106 hasta alındı. Kırıklar plafond seviyesinden 3-12 cm arası mesafede lokalize olarak belirlendi. Hastalar fibulanın durumuna göre üç gruba ayrıldı: Grup 1 bir fibula kırığı var ancak fibular fiksasyon yapılmamış, 47 vaka, Grup 2 bir fibula kırığı var, eş zamanlı fibular fiksasyon yapılmış, 38 vaka and Grup 3 intakt fibula, 21 vaka. Tüm fibular fiksasyon cerrahileri kilitli kompresyon plakları ile, tibial fiksasyon ise kiltli kompresyon plakları veya intramedüller çivileme ile yapıldı. Primer sonuç ölçütleri kaynama ve dizilim olarak belirlendi. Yaş, cinsiyet, AO sınıflaması, fibula kırık seviyesi, açık kırık varlığı, implant tipi ve cerrahiye kadar geçen süre değerlendirildi. Bulgular Açık kırık varlığı haricindeki değişkenlerin hem kaynama oranlarını hem de dizilimi etkilemediği izlendi. Kaynama oranı eş zamanlı fibula fiksasyon grubunda açık kırık varlığında anlamlı oranda daha düşük saptandı p0.001. Kapalı kırıklar lojistik regresyon analizi yapıldığında daha iyi kaynama oranlarına sahipti OR5,00 95 CI 2,24-11,48. Sonuç Mevcut çalışma distal 13 tibia kırıklarında eş zamanlı bir fibular fiksasyon ameliyatının ne kaynama oranları ne de dizilim üzerine olumlu etkisi olmadığını gösterdi. Bundan dolayı, daha iyi sonuçlar almak için distal tibia kırıklarında bir fibular fiksasyon cerrahisi zorunluluk değildir ve açık kırık varlığında hem ek cerrahinin getirdiği yük hem de daha düşük kaynama oranı nedeni ile yapılmamasını önermekteyiz.

Makale detayları

DISTAL THIRD TIBIAL FRACTURE SURGERY WITH FIBULAR FIXATION: IS IT NECESSARY FOR UNION AND ALIGNMENT?

Yazarlar:

Necmettin Turgut | Ahmet İnce | Meric Unal

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Surgery

Dergi:

Medical Journal of Süleyman Demirel University Vol.30 Issue 3, pp.308-315

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001299105

pISSN:

1300-7416

distal tibia fracture

fibula fracture

nonunion

Gustilo Anderson classification

intramedullary nailing

concurrent fibular fixationdistal tibia kırığı

fibula kırığı

kaynamama

Gustilo Anderson sınıflaması

intramedüller çivileme

eş zamanlı fibular fiksasyon

Sayı

Makale detayları

Yazarlar: Necmettin Turgut | Ahmet İnce | Meric Unal

Yayıncı: Süleyman Demirel University

Ana Başlıklar: Surgery

Dergi: Medical Journal of Süleyman Demirel University Vol.30 Issue 3, pp.308-315

Belge Tipi: Makale

Yayın Tarihi: 9/2023

Belge Dili: İngilizce

Document ID (Org No.): 2001299105

pISSN: 1300-7416

Sayı

Yazarlar:

Necmettin Turgut | Ahmet İnce | Meric Unal

Yayıncı:

Süleyman Demirel University

Ana Başlıklar:

Surgery

Dergi:

Medical Journal of Süleyman Demirel University Vol.30 Issue 3, pp.308-315

Belge Tipi:

Makale

Yayın Tarihi:

9/2023

Belge Dili:

İngilizce

Document ID (Org No.):

2001299105

pISSN:

1300-7416