![]() Closed treatment of dislocation without fracture, with manipulation (e.g., 23650-closed treatment of shoulder dislocation, with manipulation, without anesthesia)Ģ.Closed treatment of dislocation with fracture with manipulation (e.g., 23665-closed treatment of shoulder dislocation, with fracture of greater humeral tuberosity, with manipulation).Closed treatment of fracture with manipulation (e.g., 26755-closed treatment of distal phalangeal fracture, finger or thumb with manipulation).Closed treatment of fracture without manipulation (e.g., 23500-closed treatment of clavicular fracture, without manipulation).All rights reserved.There are four different forms of closed management of fractures and/or dislocations for emergency physicians: The current study shows that while good fracture reduction can be achieved, without major complications, more than fifth of patients, required secondary procedures, mainly hardware removals.Īnkle Fibular Fracture Intramedullary Nail Rod.Ĭopyright © 2017 European Foot and Ankle Society. It may be considered as treatment of choice for patients with soft tissue problems due to its minimal invasive approach. Intramedullary fibular nail offers a satisfactory and safe procedure to establish good reduction and fixation of lateral malleoli fractures. In two cases, the nail was later revised to a different fixation method: one case to a plate, due to secondary displacement at 2 weeks, and one to an intramedullary tibiotalocalcaneal arthrodesis secondary to hardware failure and Charcot neuroarthropathy. Eight patients have undergone additional surgeries, namely hardware removals. Overall no systemic complications occurred. It was determined to be good in 32 cases, fair in 5 cases and poor in 2 cases that were revised intraoperatively to plate fixation. Quality of reduction was based on previously published criteria. According to Weber classification of lateral malleolus fractures, 20 cases were type B, 18 cases type C, and one case of a pathologic fracture type B like fracture. Out of 39 cases in the study cohort, 37 were closed fractures while 2 had an associated medial malleolus open injury. Patient charts were reviewed for fracture patterns, comorbidities, quality of reduction, complications and additional surgeries. A fibular nail was utilized for the treatment of various ankle fractures either as the sole method of fixation or combined with another method. Thirty-nine cases treated with fibula intramedullary nailing between the years 2014-2016 were retrospectively studied. This study evaluates the use of fibula intramedullary nailing based on minimal invasive surgical approach. The current gold standard of treating unstable fractures is with open reduction and internal fixation (ORIF), using plates and screws construct. Techniques for fixation of displaced fractures of the lateral malleolus have remained essentially unchanged in recent decades. Ankle fractures are extremely common and represent nearly one quarter of all lower-limb fractures.
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