Fibular nailing versus open reduction plate fixation for unstable ankle fractures in the young
Objective To compare the clinical efficacy of fibular nailing vs.open reduction fibular plate fixation in the treatment of unstable ankle fractures in young patients.Methods A prospective analysis was con-ducted on clinical data of 52 young patients with unstable ankle fractures admitted to our hospital from Jan.2022 to Dec.2022,including 30 males and 22 females aged 18-60(mean 49.1)years.Patients were randomly divided into fibular nailing group and open reduction plate fixation(ORPF)group(n=26 for each).The preoperative waiting time,operation time,number of intraoperative fluoroscopies,time to bone union,ankle function,and complications of the two groups were recorded and compared.Results There was no significant difference in general information be-tween the two groups,including gender,age,BMI,injury causes and fracture classifications(all P>0.05).Com-pared with the ORPF group,the fibular nailing group revealed a much shorter preoperative waiting time(d,4.7±1.7 vs.7.6±1.9,P=0.008)and similar operation time(min,81.4±7.6 vs.75.5±6.3,P=0.104),but much more frequent intraoperative fluoroscopy(7.9±1.4 vs.4.8±1.2,P<0.001).All patients were followed up for 10-20 months,which showed no significant difference in terms of time to bone union(months,4.4±1.0 and 4.1±1.0)and AOFAS ankle-hindfoot score at the last follow-up(84.8±16.3 vs.82.1±19.4)between the two groups(both P>0.05).In addition,the fibular nailing group had fewer cases with postoperative complications(3 vs.5,P=0.223)and incision-related complications(1 vs.4,P=0.158),but the difference was insignificant compared with the ORPF group.The internal fixators were removed in 6 cases(23.1%)in the fibular nailing group,significantly fewer than the 12 cases(46.2%)in the ORPF group(P=0.048).Conclusion Both fibular nailing and ORPF are effective and safe methods for treating unstable ankle fractures in young patients,and the former showed fewer complications but more frequent intraoperative fluoroscopy.
Unstable ankle fracturesFibular nailingOpen reduction and plate fixationFunctional scoreComplications
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