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Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures

Standard

Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures. / Schröder, M; Stüber, V; Walendzik, E; O'Loughlin, P F; Zapf, A; Krettek, C; Gaulke, R.

in: TECHNOL HEALTH CARE, Jahrgang 23, Nr. 2, 2015, S. 215-221.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Schröder, M, Stüber, V, Walendzik, E, O'Loughlin, PF, Zapf, A, Krettek, C & Gaulke, R 2015, 'Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures', TECHNOL HEALTH CARE, Jg. 23, Nr. 2, S. 215-221. https://doi.org/10.3233/THC-140885

APA

Schröder, M., Stüber, V., Walendzik, E., O'Loughlin, P. F., Zapf, A., Krettek, C., & Gaulke, R. (2015). Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures. TECHNOL HEALTH CARE, 23(2), 215-221. https://doi.org/10.3233/THC-140885

Vancouver

Schröder M, Stüber V, Walendzik E, O'Loughlin PF, Zapf A, Krettek C et al. Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures. TECHNOL HEALTH CARE. 2015;23(2):215-221. https://doi.org/10.3233/THC-140885

Bibtex

@article{02973509aaa84d7788f059c8620177d6,
title = "Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures",
abstract = "OBJECTIVE: In unstable ankle fractures the associated soft tissue damage can be a therapeutic challenge. The aim of this study was to optimize planning of minimally invasive stabilization of ankle fractures by calcaneotibial transfixation, which is a demanding technique due to the complex hind foot anatomy.METHODS: In a retrospective radiographic analysis the angles and dimensions of a safe drill tunnel for calcaneotibial K-wire insertion were defined on standard radiographs of the ankle joint. 165 lateral weight-bearing radiographs (77 right; 88 left) and 147 (80 right; 67 left) mortise views of 186 (90 right; 96 left) uninjured feet from 123 patients (74 women (114 feet); 49 men (72 feet)) were included in this study. The average patient age was 49 (range, 13-85) years. Inter- and intra-observer reliability was evaluated on 20 randomized radiographs that were analyzed in a default set, three times, by two different examiners on three different days.RESULTS: In the lateral view the drilling tunnel was orientated at 59.4° to the plantar plane with a maximum proximal variance of 7.1 image-mm. Distal variance cannot be tolerated since an ankle joint injury would ensue. In the mortise view the drill tunnel was directed with a mean angle of 18.4° to the distal tibial articular surface. At most a mean of 11° fibular- and 13.4° tibial- expansion can be tolerated. Intra- and inter-observer reliability was higher for the angles than for the drill corridors.CONCLUSION: The three-dimensional (3D) orientation for safe K-wire placement for calcaneotibial transfixation should adhere to the drill tunnels established in this study.",
keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Ankle Fractures, Bone Wires, Calcaneus, Female, Fracture Fixation, Internal, Humans, Male, Middle Aged, Observer Variation, Retrospective Studies, Tibia, Treatment Outcome, Weight-Bearing, Young Adult, Journal Article, Randomized Controlled Trial",
author = "M Schr{\"o}der and V St{\"u}ber and E Walendzik and O'Loughlin, {P F} and A Zapf and C Krettek and R Gaulke",
year = "2015",
doi = "10.3233/THC-140885",
language = "English",
volume = "23",
pages = "215--221",
journal = "TECHNOL HEALTH CARE",
issn = "0928-7329",
publisher = "IOS Press",
number = "2",

}

RIS

TY - JOUR

T1 - Establishing an optimal trajectory for calcaneotibial K-wire fixation in emergent treatment of unstable ankle fractures

AU - Schröder, M

AU - Stüber, V

AU - Walendzik, E

AU - O'Loughlin, P F

AU - Zapf, A

AU - Krettek, C

AU - Gaulke, R

PY - 2015

Y1 - 2015

N2 - OBJECTIVE: In unstable ankle fractures the associated soft tissue damage can be a therapeutic challenge. The aim of this study was to optimize planning of minimally invasive stabilization of ankle fractures by calcaneotibial transfixation, which is a demanding technique due to the complex hind foot anatomy.METHODS: In a retrospective radiographic analysis the angles and dimensions of a safe drill tunnel for calcaneotibial K-wire insertion were defined on standard radiographs of the ankle joint. 165 lateral weight-bearing radiographs (77 right; 88 left) and 147 (80 right; 67 left) mortise views of 186 (90 right; 96 left) uninjured feet from 123 patients (74 women (114 feet); 49 men (72 feet)) were included in this study. The average patient age was 49 (range, 13-85) years. Inter- and intra-observer reliability was evaluated on 20 randomized radiographs that were analyzed in a default set, three times, by two different examiners on three different days.RESULTS: In the lateral view the drilling tunnel was orientated at 59.4° to the plantar plane with a maximum proximal variance of 7.1 image-mm. Distal variance cannot be tolerated since an ankle joint injury would ensue. In the mortise view the drill tunnel was directed with a mean angle of 18.4° to the distal tibial articular surface. At most a mean of 11° fibular- and 13.4° tibial- expansion can be tolerated. Intra- and inter-observer reliability was higher for the angles than for the drill corridors.CONCLUSION: The three-dimensional (3D) orientation for safe K-wire placement for calcaneotibial transfixation should adhere to the drill tunnels established in this study.

AB - OBJECTIVE: In unstable ankle fractures the associated soft tissue damage can be a therapeutic challenge. The aim of this study was to optimize planning of minimally invasive stabilization of ankle fractures by calcaneotibial transfixation, which is a demanding technique due to the complex hind foot anatomy.METHODS: In a retrospective radiographic analysis the angles and dimensions of a safe drill tunnel for calcaneotibial K-wire insertion were defined on standard radiographs of the ankle joint. 165 lateral weight-bearing radiographs (77 right; 88 left) and 147 (80 right; 67 left) mortise views of 186 (90 right; 96 left) uninjured feet from 123 patients (74 women (114 feet); 49 men (72 feet)) were included in this study. The average patient age was 49 (range, 13-85) years. Inter- and intra-observer reliability was evaluated on 20 randomized radiographs that were analyzed in a default set, three times, by two different examiners on three different days.RESULTS: In the lateral view the drilling tunnel was orientated at 59.4° to the plantar plane with a maximum proximal variance of 7.1 image-mm. Distal variance cannot be tolerated since an ankle joint injury would ensue. In the mortise view the drill tunnel was directed with a mean angle of 18.4° to the distal tibial articular surface. At most a mean of 11° fibular- and 13.4° tibial- expansion can be tolerated. Intra- and inter-observer reliability was higher for the angles than for the drill corridors.CONCLUSION: The three-dimensional (3D) orientation for safe K-wire placement for calcaneotibial transfixation should adhere to the drill tunnels established in this study.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Ankle Fractures

KW - Bone Wires

KW - Calcaneus

KW - Female

KW - Fracture Fixation, Internal

KW - Humans

KW - Male

KW - Middle Aged

KW - Observer Variation

KW - Retrospective Studies

KW - Tibia

KW - Treatment Outcome

KW - Weight-Bearing

KW - Young Adult

KW - Journal Article

KW - Randomized Controlled Trial

U2 - 10.3233/THC-140885

DO - 10.3233/THC-140885

M3 - SCORING: Journal article

C2 - 25503697

VL - 23

SP - 215

EP - 221

JO - TECHNOL HEALTH CARE

JF - TECHNOL HEALTH CARE

SN - 0928-7329

IS - 2

ER -