Nuestro objetivo ha sido analizar los resultados clínico-funcionales de las fracturas de tobillo con afectación del canto posterior, tratadas de forma quirúrgica sin reducción directa del tercer maléolo. ConclusionĪnkle fractures involving the posterior malleolus seem to contribute to the development of early-onset osteoarthritis with functional limitation in young adults.Īl menos el 10% de las fracturas de tobillo presentan afectación del maléolo posterior de la tibia, lo cual se ha relacionado con peor pronóstico a largo plazo. We found that a larger posterior fragment size related to a greater degree of early-onset osteoarthritis ( p < 0.03) and poorer AOFAS scores ( p < 0.01). Of the patients, 55.6% had involvement of between 19% and 25% of the joint surface. Up to 18% of the patients developed radiographically significant osteoarthritis in the short and medium term (between 12 and 73 months, with a mean of 33 months). The mean VAS pain score of the sample was 1.1 (0–5) at rest and 3 (0–8) on exercise 88.4 ± 10.1 on the AOFAS scale, and 68.5 ± 19.3 points on the SF-36. We performed a retrospective study of 45 patients aged under 60, who we classified into three groups in terms of the percentage of joint involvement of the posterior fragment (25%) assessing the functional outcomes using the visual analogue pain scale (VAS), the AOFAS scale ( American Orthopedic Foot and Ankle Society) of the ankle and hindfoot and the global health questionnaire SF-36 we also analysed the degree of osteoarthritis with weight-bearing radiography, at least one year following the injury. Our aim was to analyse the clinical and functional outcomes of ankle fractures involving the posterior edge, treated surgically without direct reduction of the third malleolus. The Journal is included in the major databases: MEDLINE/PubMed, IME, EMBASE, Bibliomed, SCOPUS, and IBECS.Īt least 10% of ankle fractures involve the posterior malleolus of the tibia, which has been related to poorer long-term prognosis. All works are evaluated blind by at least 3 peer reviewers, whose judgements are finally supervised by the Editor of the particular area of knowledge and by the Journal Editor in Chief. The Editorial Committee consists of 10 independent members, specialists of recognised prestige that are not associated with the governing bodies of the Society. The Updates and Research Works sections are of great interest to specialists, due to the careful selection of the topics. In each issue it also publishes one or two clinical cases that are of great interest to the readers, since they are usually exceptional cases that are difficult to diagnose or treat. In the contents of the Journal, priority is given to original research articles on the specialty, which is also its main aim the publication of the best original research articles in Spanish. This is particularly helpful in the distal tibia when the plain film can under-estimate the complexity and severity of a distal tibial injury.The Revista Española de Cirugía Ortopédica y Traumatología (Journal of Orthopaedics Surgery and Traumatology) is the official publication of the Spanish Society of Orthopaedic Surgery and Traumatology that has a combined total of 5,000 members, and is the leading Spanish journal of the specialty. Lucent fracture line extending through the metaphysis, across physis, and into the epiphysisĪngulation, displacement, and rotation may occurĪdjacent soft tissue swelling and joint effusion may be notedĬT may be helpful to further assess the nature of the fracture. Salter-Harris type IV injuries will often follow typical location patterns and most commonly involve the distal radius, phalanges, and distal tibia. EpidemiologyĪpproximately 10-12% of all physeal fractures will be a Salter-Harris type IV fracture. Salter-Harris IV injuries typically have a poor prognosis due to interruption of the proliferative and reserve cartilage zones often leading to altered joint mechanics and functional impairment and as such orthopedic evaluation and subsequent operative intervention are often required 1,2. Salter-Harris fractures are a group of childhood injuries where a fracture involves the physis. They are intra-articular injuries in which the fracture extends through the epiphysis, across the physis, and through the metaphysis. Salter-Harris type IV fractures are relatively uncommon injuries that occur in children.
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