Minimally Invasive Plate Osteosynthesis for Treatment of Ankle Fractures in High-Risk Patients

Irina Bazarov, Jason Kim, Johanna M. Richey, Joseph D. Dickinson, Graham A. Hamilton

Producción científica: Articlerevisión exhaustiva

9 Citas (Scopus)


Wound healing problems are the most common complication after open reduction with internal fixation (ORIF) of unstable ankle fractures. The incidence is especially high among elderly patients with medical comorbidities and patients with compromised soft tissues. Minimally invasive plate osteosynthesis (MIPO) might provide a safer alternative to ORIF by preventing extensive soft tissue dissection and preserving the blood supply. We conducted a retrospective review of 44 consecutive patients who had undergone MIPO of unstable ankle fractures. All patients had a minimum 1-year follow-up (mean 82 weeks); 80% were aged ≥60 years, 52% had diabetes, and 45% had a compromised soft tissue envelope. Immediate postoperative radiographs were evaluated for the quality of reduction, and clinical records were analyzed for the complication rate. Good to excellent anatomic reduction was achieved in 89% of the patients. The overall complication rate was 27%, including 25% surgical wound dehiscence, 9% infection, and 11% loss of reduction. No patient experienced nerve injury. Those with a history of ankle fracture dislocation and a compromised soft tissue envelope preoperatively had a significantly greater incidence of surgical wound dehiscence and complications overall compared with those without (p =.016 and p =.035; p =.045 and p =.009, respectively). Peripheral vascular disease was a statistically significant predictor of surgical wound dehiscence (p =.010). The overall complication rate in our study was comparable to that seen in similar populations treated with conventional ORIF. In conclusion, our results suggest that MIPO in high-risk patients is a safe alternative, with predictable outcomes, comparable to those of traditional open techniques.

Idioma originalEnglish (US)
Páginas (desde-hasta)494-500
Número de páginas7
PublicaciónJournal of Foot and Ankle Surgery
EstadoPublished - may 1 2018
Publicado de forma externa

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine


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