DOS 2020

DOS Kongressen 2020 · 17 Risk of reoperation when comparing locking plate with non-locking plate in ankle fractures Gudrun Holm Jacobsen, Mads Holm Gude, Bjarke Viberg, Per Hviid Gundtoft Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital, University Hospital of Southern Denmark Background: Locking plate is designed for better stability in fractures with poor bone quality but is today widely used - also in patients with normal bone quality. The literature is sparse regarding the benefit of locking plate in ankle fractures. Purpose / Aim of Study: The aim is to compare the risk of reoperation for locking plate with non-locking plate in patients with ankle fractures. Secondary, to investigate the distribution of locking plate use in Denmark. Materials and Methods: The study is a population based register study. Data on patients with AO type 44A1/2 and 44B1/2 treated with either locking or non-locking plate were obtained from the Danish Fracture Database for the pe- riod March 15, 2012 to December 31, 2016. The follow-up period was 24 months. Data were linked with the Danish National Patient Registry to ensure complete information on reoperations, which were divided into major and mi- nor complications. Major complications were defined as complications needing surgical intervention with the exception of simple hardware removal, which was defined as minor complications. Multivariate regression analysis was performed for relative risk (RR) adjusted for age, sex, American Society of Anesthesiologists Classification (ASA) and level of surgeons experience. All results are reported with 95% confidence interval. Findings / Results: A total of 2,177 ankles fractures were included of which 718 (33%) were treated with locking plate and 1,459 (67%) with non-locking plate. The mean age was higher in the locking plate group (p<0.001) and locking plate was used more often in women (p=0.018), in patients with higher ASA- score (p<0.001), and in patients operated by consultants (p=0.018). In both groups the risk was 3% for major complications and 22% for minor. The adjusted RR of major reoperation was 1.00 (0.66;1.66) for locking plate compared to non-locking plate and 0.92 (0.76;1.11) for minor reoperation. The proportion of locking plate use varied widely between departments, ranging from 6% to 61%. Conclusions: There is no difference in association to reoperation when com- paring locking plate with non-locking plates in patients with surgical treated ankle fracture. The indication of locking plate use should be evaluated on all hospitals. 11.