Percutaneous intramedullary screw or rush pin fixation of unstable ankle fractures in patients with fragile soft tissue – retrospective study of 80 cases

TY - JOUR

T1 - Percutaneous intramedullary screw or rush pin fixation of unstable ankle fractures in patients with fragile soft tissue – retrospective study of 80 cases

AU - Mortensen, Simon Oksbjerre

AU - Barckman, Jeppe

AU - Gundtoft, Per Hviid

N1 - Publisher Copyright: © The Author(s) 2024.

PY - 2024/5

Y1 - 2024/5

N2 - Introduction: The standard surgical procedure for unstable ankle fractures is fixation of the lateral malleolus with a plate and screws. This method has a high risk of complications, especially among patients with fragile skin conditions. The aim of this study was to estimate the re-operation rates and identify complications in patients with an unstable ankle fracture, surgically treated with an intramedullary screw or rush pin. Materials and methods: We identified all patients who were surgically treated with either a 3.5-mm screw or rush pin at Aarhus University Hospital, Denmark, from 2012 to 2018. Major complications were re-operations within three months. We included 80 patients, of which 55 (69%) were treated with a 3.5-mm intramedullary screw and 25 (31%) with a rush pin. The majority of the study population was female (59) and the mean age was 75 (range 24 to 100) years. Of the 80 patients included, 41 patients had more than 2 comorbidities. Results: Three patients underwent re-operation within three months due to either fracture displacement or hardware cutout. Radiographs obtained after six weeks showed that nine patients had loss of reduction. Additionally, four patients had superficial wound infections and six patients had delayed wound healing. Conclusions: Intramedullary fixation of distal fibula fractures with either a screw or rush pin has low re-operation rates. However, the high proportion of patients with radiological loss of reduction is concerning.

AB - Introduction: The standard surgical procedure for unstable ankle fractures is fixation of the lateral malleolus with a plate and screws. This method has a high risk of complications, especially among patients with fragile skin conditions. The aim of this study was to estimate the re-operation rates and identify complications in patients with an unstable ankle fracture, surgically treated with an intramedullary screw or rush pin. Materials and methods: We identified all patients who were surgically treated with either a 3.5-mm screw or rush pin at Aarhus University Hospital, Denmark, from 2012 to 2018. Major complications were re-operations within three months. We included 80 patients, of which 55 (69%) were treated with a 3.5-mm intramedullary screw and 25 (31%) with a rush pin. The majority of the study population was female (59) and the mean age was 75 (range 24 to 100) years. Of the 80 patients included, 41 patients had more than 2 comorbidities. Results: Three patients underwent re-operation within three months due to either fracture displacement or hardware cutout. Radiographs obtained after six weeks showed that nine patients had loss of reduction. Additionally, four patients had superficial wound infections and six patients had delayed wound healing. Conclusions: Intramedullary fixation of distal fibula fractures with either a screw or rush pin has low re-operation rates. However, the high proportion of patients with radiological loss of reduction is concerning.

KW - Distal fibula fracture

KW - Fibula rush pin

KW - Fragile skin conditions

KW - Re-operation

KW - Soft tissue complications

KW - Fracture Fixation, Intramedullary/methods

KW - Bone Nails

KW - Bone Screws

KW - Humans

KW - Ankle Fractures/surgery

KW - Middle Aged

KW - Male

KW - Reoperation/statistics & numerical data

KW - Young Adult

KW - Postoperative Complications/epidemiology

KW - Aged, 80 and over

KW - Female

KW - Adult

KW - Retrospective Studies

KW - Aged

UR - http://www.scopus.com/inward/record.url?scp=85190478355&partnerID=8YFLogxK

U2 - 10.1007/s00402-024-05290-w

DO - 10.1007/s00402-024-05290-w

M3 - Journal article

C2 - 38613611

AN - SCOPUS:85190478355

SN - 0936-8051

VL - 144

SP - 2157

EP - 2163

JO - Archives of Orthopaedic and Trauma Surgery

JF - Archives of Orthopaedic and Trauma Surgery

IS - 5

ER -