DOS 2017

166

· DOS Abstracts

A Prospective RCT comparing The Fibular Nail vs

ORIF in Ankle Fractures in adult patients under age

stud med Linea H Lundholm, Bjørn L Madsen, Kim Holck, stud med Lucy H Olsen,

Andrew D Ducksworth, Tim O White

OrthopedicSurgery, Hvidovre University Hospital, Edinburgh Royal Infirmary;

OrthopedicSurgery, Edinburgh Royal Infirmary; OrthopedicSurgery, Edinburgh

Royal Infirmary

Background:

The standard treatment for lateral malleolar fractures has for a

long period been ORIF with screws and plates. In recent years a new fixation,

fibular nail, has been developed for treating the fractures in a less invasive man-

ner. An RCT study in the age group above 65 did show an advantage in the form

of significantly fewer wound complications and deep infections.

Purpose / Aim of Study:

The purpose of this is to compare the outcomes of

fibular nailing vs standard ORIF of ankle fractures in patients under the age of

65.

Materials and Methods:

The study was conducted as a multicenter, RCT

study including Hvidovre University Hospital and Edinburgh Royal Infirmary. All

patients between the age of 18-65 suffering a lateral malleolar fracture were

included after oral and written consent, independently of an eventual medial

malleolar fracture. All patients were followed for two years. The outcome was

evaluated as a combination of radiographic results, PROM and a clinical exami-

nation including wound appearance.

Findings / Results:

A total of 127 patients were included. Three patients with-

drew their consent during the course of the study, two with plate and 1 nail.

In terms of wound complications, the groups were similar, though there was

a tendency towards more wound pain in the plate group. One severe wound

breakdown occurred in the plate group. In the nail group five patients had to be

treated with a plate, in four due to narrow fibular canal and one due to commi-

nuted distal fracture.

Conclusions:

In young patients fibular nailing is a reliable method of fixation,

as the ORIF and nail showed equivalent clinical outcomes. Unlike in the elder

age group, the nail did not show any significant advantage in preventing wound

complications. The nail is an addition to the armoury in the treatment of ankle

fractures.

No conflicts of interest reported

118.