Unfallchirurgie (Heidelberg, Germany) · 2026
[Operative treatment of ankle fractures-what about biomechanics? : From angle stability to nail fixation].
СтатьяСистематический обзорАннотация на английскомНазвание и аннотация: Перевод в очереди
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Förch Stefan, Bonhorst P, Mayr E
Аннотация
BACKGROUND: Ankle fractures in geriatric patients represent a relevant and not yet definitively resolved problem in everyday trauma surgery practice.
OBJECTIVE: Are there biomechanical studies on different osteosynthesis techniques for treatment of the fibula in geriatric ankle fractures, and can the superiority of one method be demonstrated?
MATERIALS AND METHODS: The article comprises a systematic literature review on the biomechanics of various osteosynthesis techniques for geriatric ankle fractures.
RESULTS: There are several biomechanical studies on different osteosynthesis techniques. However, only isolated studies are available on additional Kirschner wires, plates with quadrocortical screws, double-plate osteosynthesis, and intramedullary nail fixation. The dorsal antiglide plate has been studied more extensively; however, no advantage over the angular-stable lateral plate could be demonstrated. The strongest body of evidence exists for angular-stable plate osteosynthesis. Nevertheless, a meta-analysis was unable to demonstrate overall superiority, although it suggests a theoretical advantage in osteoporotic bone.
CONCLUSION: From a biomechanical perspective, the ideal osteosynthesis technique for treatment of the fibula in geriatric ankle fractures has not yet been identified.
OBJECTIVE: Are there biomechanical studies on different osteosynthesis techniques for treatment of the fibula in geriatric ankle fractures, and can the superiority of one method be demonstrated?
MATERIALS AND METHODS: The article comprises a systematic literature review on the biomechanics of various osteosynthesis techniques for geriatric ankle fractures.
RESULTS: There are several biomechanical studies on different osteosynthesis techniques. However, only isolated studies are available on additional Kirschner wires, plates with quadrocortical screws, double-plate osteosynthesis, and intramedullary nail fixation. The dorsal antiglide plate has been studied more extensively; however, no advantage over the angular-stable lateral plate could be demonstrated. The strongest body of evidence exists for angular-stable plate osteosynthesis. Nevertheless, a meta-analysis was unable to demonstrate overall superiority, although it suggests a theoretical advantage in osteoporotic bone.
CONCLUSION: From a biomechanical perspective, the ideal osteosynthesis technique for treatment of the fibula in geriatric ankle fractures has not yet been identified.