Evola FR, Di Fede GF, Evola G, Barchitta M, Agodi A, Longo G. Locking plates for distal fibula fractures in young and elderly patients: A retrospective study. World J Orthop 2023; 14(7): 540-546 [PMID: 37485428 DOI: 10.5312/wjo.v14.i7.540]
Corresponding Author of This Article
Francesco Roberto Evola, MD, PhD, Additional Professor, Department of Surgery, Division of Orthopedics and Trauma Surgery, “Cannizzaro” Hospital, MESSINA n° 829, Catania 95100, Italy. robertoevola@virgilio.it
Research Domain of This Article
Orthopedics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Jul 18, 2023; 14(7): 540-546 Published online Jul 18, 2023. doi: 10.5312/wjo.v14.i7.540
Locking plates for distal fibula fractures in young and elderly patients: A retrospective study
Francesco Roberto Evola, Giovanni Francesco Di Fede, Giuseppe Evola, Martina Barchitta, Antonella Agodi, Gianfranco Longo
Francesco Roberto Evola, Gianfranco Longo, Department of Surgery, Division of Orthopedics and Trauma Surgery, “Cannizzaro” Hospital, Catania 95100, Italy
Giovanni Francesco Di Fede, Department of Radiodiagnostics, Division of Radiology, “S. Marta and S. Venera” Hospital, Acireale 95024, Italy
Giuseppe Evola, Department of Surgery, Division of Surgery, “Garibaldi” Hospital, Catania 95100, Italy
Martina Barchitta, Antonella Agodi, Department of Medical and Surgical Sciences and Advanced Technologies “GF Ingrassia”, University of Catania, Catania 95100, Italy
Author contributions: All authors designed the study, acquired and interpreted the data, wrote the manuscript, and approved the final version of the article; Evola FR and Di Fede GF designed and performed the research; Evola FR and Evola G contributed to the literature research; Agodi A and Barchitta M analysed the data; Evola FR wrote the paper; Longo G revised the manuscript; All authors read and approved the final manuscript.
Institutional review board statement: The permission of this study was obtained from our Institutional Ethics Committee for the use of patient data for publication purpose (n°161/2020/CA).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Francesco Roberto Evola, MD, PhD, Additional Professor, Department of Surgery, Division of Orthopedics and Trauma Surgery, “Cannizzaro” Hospital, MESSINA n° 829, Catania 95100, Italy. robertoevola@virgilio.it
Received: December 29, 2022 Peer-review started: December 29, 2022 First decision: March 14, 2023 Revised: April 16, 2023 Accepted: June 6, 2023 Article in press: June 6, 2023 Published online: July 18, 2023
Abstract
BACKGROUND
Ankle fractures are common injuries in the young and elderly populations. To prevent post-traumatic arthritis, an anatomic reconstruction of the ankle structure is mandatory. Open reduction and internal fixation is the treatment of choice among orthopaedics. Conventional plates allow stability of the fracture if bone quality is present. Locking plates might offer an advantage for the treatment of lateral malleolar fracture in patients with comminution, severe instability, distal fractures, or osteoporotic bone. Our hospital introduced a new locking plate for fracture of the distal fibula.
AIM
To evaluate locking plates in terms of outcomes and complications in young and elderly patients.
METHODS
We retrospectively reviewed a total of 67 patients treated for displaced distal fibula fractures. Demographic data, number of comorbidities, use of inter fragmentary screw, complication, time of fracture healing, partial or full weight bearing, and reoperation were recorded for all patients. Clinical outcome was assessed by the American Orthopedic Foot and Ankle Society clinical scoring system. Radiographs were obtained at 4, 8, 12, 16, 20, and 24 wk until radiographic union was obtained.
RESULTS
All patients displayed complete bony union on radiographic assessment, and no patients developed any serious complications. We observed two superficial infections, one delayed wound healing, and two plate intolerances. Significant differences were observed between the two age groups in terms of radiographic healing (11.9 wk in younger patients vs 13.7 wk in older patients; P = 0.011) and in the American Orthopedic Foot and Ankle Society score at 6 mo after surgery (88.2 in younger patients vs 86.0 in older patients; P = 0.001) and at 12 mo after surgery (92.6 in younger patients vs 90.0 in older patients; P = 0.000).
CONCLUSION
Locking plates provide a stable and rigid fixation in multifragmentary and comminuted fractures or in the presence of poor bone quality.
Core Tip: Ankle fractures are common injuries in the young and elderly populations. Fibula locking plate is used for the older population due to osteoporotic bone or for the younger population with multifragmentary and comminuted fractures. We introduced a new locking plate for fracture of the distal fibula and evaluated it for lateral malleolar fixation in terms of outcomes and complications in young and elderly patients. We were interested in determining whether the use of this locking plate would provide the same advantage and outcomes that were described in literature.
