PMID- 35505429
OWN - NLM
STAT- MEDLINE
DCOM- 20220505
LR  - 20220716
IS  - 1749-799X (Electronic)
IS  - 1749-799X (Linking)
VI  - 17
IP  - 1
DP  - 2022 May 3
TI  - Surgical treatment of displaced isolated lateral malleolar fractures: incidence 
      of adverse events requiring revision: a retrospective cohort study.
PG  - 252
LID - 10.1186/s13018-022-03135-z [doi]
LID - 252
AB  - BACKGROUND: Recent systematic reviews support that non-operative management 
      should be the standard treatment for all stable isolated lateral malleolar 
      fractures (ILMFs), regardless of fibular fracture displacement. Surgical fixation 
      of ILMFs carries a risk of adverse events (AEs), and many patients will later 
      require implant removal. We wanted to estimate the incidence of AEs requiring 
      revision after surgical fixation of "potentially stable" displaced ILMFs before 
      non-operative treatment became standard care in our department. MATERIALS AND 
      METHODS: To identify patients with "potentially stable" ILMFs who had been 
      treated surgically in a historical cohort, we retrospectively applied the 
      stability-based classification system, introduced by Michelson et al., to a 
      cohort of 1006 patients with ankle fractures treated surgically from 2011 to 
      2016. The primary outcome of this retrospective cohort study was the incidence of 
      AEs that had functionally significant adverse effects on outcome and required 
      revision in the first 12 months after surgery. AEs were graded and categorized 
      using the Orthopedic Surgical Adverse Events Severity (OrthoSAVES) System. 
      RESULTS: The study population comprised 108 patients with "potentially stable" 
      displaced ILMFs; 4 patients (3.7% [95% CI (0.1-7.3%]) experienced AEs requiring 
      revision in the first twelve months after surgery. There were 5 additional 
      patients (4.6%) with functionally significant AEs where revision surgery was not 
      indicated within the first twelve months after surgical fixation. A further 5 
      patients (4.6%) had AEs managed in the outpatient clinic (grade II); 36 patients 
      (33.3%) required secondary implant removal due to implant-related discomfort. 
      CONCLUSIONS: Surgical fixation of ILMFs carries a risk of severe AEs, and many 
      patients will subsequently need implant-removal procedures. Further prospective 
      studies are required to ascertain whether non-operative treatment can lower the 
      risk of AEs and the need for additional surgical procedures.
CI  - (c) 2022. The Author(s).
FAU - Frederiksen, Jonas Ordell
AU  - Frederiksen JO
AUID- ORCID: 0000-0001-9848-6915
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark. ordell.jonas@gmail.com.
FAU - Malmberg, Catarina
AU  - Malmberg C
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark.
FAU - Karimi, Dennis
AU  - Karimi D
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark.
FAU - Tengberg, Peter Toft
AU  - Tengberg PT
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark.
FAU - Troelsen, Anders
AU  - Troelsen A
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark.
FAU - Terndrup, Mads
AU  - Terndrup M
AD  - Department of Orthopedic Surgery, Copenhagen University Hospital Hvidovre, 
      Kettegardsalle 30, 2650, Hvidovre, Denmark.
LA  - eng
PT  - Journal Article
DEP - 20220503
PL  - England
TA  - J Orthop Surg Res
JT  - Journal of orthopaedic surgery and research
JID - 101265112
SB  - IM
MH  - *Ankle Fractures/surgery
MH  - Cohort Studies
MH  - Humans
MH  - Incidence
MH  - Prospective Studies
MH  - Retrospective Studies
PMC - PMC9066775
OTO - NOTNLM
OT  - Adverse events
OT  - Ankle fractures
OT  - Isolated lateral malleolar fractures
OT  - Stability-based classification
OT  - Talar shift
COIS- The authors declare that they have no competing interests. Separate disclosure 
      forms from all authors are submitted alongside this manuscript.
EDAT- 2022/05/04 06:00
MHDA- 2022/05/06 06:00
PMCR- 2022/05/03
CRDT- 2022/05/03 23:52
PHST- 2022/01/21 00:00 [received]
PHST- 2022/04/19 00:00 [accepted]
PHST- 2022/05/03 23:52 [entrez]
PHST- 2022/05/04 06:00 [pubmed]
PHST- 2022/05/06 06:00 [medline]
PHST- 2022/05/03 00:00 [pmc-release]
AID - 10.1186/s13018-022-03135-z [pii]
AID - 3135 [pii]
AID - 10.1186/s13018-022-03135-z [doi]
PST - epublish
SO  - J Orthop Surg Res. 2022 May 3;17(1):252. doi: 10.1186/s13018-022-03135-z.