DOS 2018

DOS Kongressen 2018 · 257 Complication and reoperation rates following fixation of potentially stable lateral unimalleolar Weber B type fractures AO44B1 - a retrospective cohort study Jonas Frederiksen, Catarina Malmberg, Ilija Ban, Peter Toft Tengberg, Mads Terndrup Department of Orthopedics, Copenhagen University Hospital Hvidovre Background: Indications for operative treatment of unimalleolar Weber B type fracture have been based on predictions of potential instability and risk of ar- thritis. These injuries could however also be interpreted as potentially stable Purpose / Aim of Study: To examine risk factors and complication rates after osteosynthesis of lateral unimalleolar Weber B type fractures (AO44B1) Materials and Methods: Adult patients with ankle fractures treated surgically from June 2011 to December 2015 at our institution were assessed for eligibil- ity. Exclusion criteria were: non-Danish citizen, non-operative treatment, treat- ment >4 weeks after injury or staged procedures, follow-up at an alternative institution, and patients lost to follow-up. Demographics and injury-related risk factors, as well as procedural data, were recorded and fractures were classified from standard radiographs and, if present, CT-scans. Postoperative data includ- ed immobilization regime, access to physiotherapy, complications, unplanned reoperation, and implant removal. Minimum follow-up was 18 months Findings / Results: 764 patients were reviewed. 113 patients had unimalleolar Weber B fractures without talar shift on initial radiographs and were classified as AO44B1. Direct lateral approach was chosen in 96% of cases, with semitubular plate and lag screw being the preferable fixation technique (87%). Syndesmotic fixation was found indicated in 5 patients. 51 patients (45%) were not allowed to fully weight bear from day one. 17 patients (15%) suffered complications. 7 patients(6.2%) required reoperation within the first year and 27.4% needed to have the implants removed Conclusions: ORIF of AO44B1 fractures is not without risk. We propose that AO44B1 fractures could be viewed as potentially stable and thus initially man- aged non-operatively. Prospective study designs should lead further investiga- tion 198.