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A Novel Approach to Medial Malleolus Fracture of Ankle using Adjustable Loop Suspensory Fixation

Journal of Clinical Orthopaedics | Vol 9 | Issue 2 |  July-December 2024 | page: 132-136 | Sandeep Deore, Sachin Kale, Sunil Shetty, Ajit Chalak, Rohan Jayaram, Roonam Patir

DOI: https://doi.org/10.13107/jcorth.2024.v09i02.698

Submitted Date: 29 Jul 2024, Review Date: 15 Aug 2024, Accepted Date: 18 Sep 2024 & Published Date: 10 Dec 2024


Author: Sandeep Deore [1], Sachin Kale [1], Sunil Shetty [1], Ajit Chalak [2], Rohan Jayaram [1], Roonam Patir [1]

[1] Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India,
[2] Department of Orthopaedics, MGM Medical College, Navi Mumbai, Maharashtra, India.

Address of Correspondence

Dr. Rohan Jayaram,
Department of Orthopaedics, Dr. D.Y. Patil Medical College and Hospital, Navi Mumbai, Maharashtra, India.
E-mail: drrohanjayaram@gmail.com


Abstract

Medial malleolar fractures are traditionally treated by orthopaedic surgeons using cancellous screws, plates, and tension banding with stainless steel wires. However, a considerable proportion of these patients eventually require revision surgery or implant removal due to complications such as wire migration, impingement, breakage, and infection. Revision surgeries for previously operated malleolar fractures pose challenges due to dilated bone tracks and osteopenia which complicate securing the mechanical hold of the implant. A potential solution to mitigating these factors could be the use of high strength polyethylene suture material such as fibre-wire to fix the fracture fragments which are held in place by a cortical button on either side. This study aims to evaluate the clinical and radiological outcomes in a patient with medial malleolus fracture fixed by fibre-wire fixation as an alternative modality of treatment.
Keywords: Medial malleolar fractures, tension band principle, stainless steel wire, implant breakage, revision surgery, suspensory fixation using fiber-wire, magnetic resonance imaging compatible construct.


References

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How to Cite this article: Deore S, Kale S, Shetty S, Chalak A, Jayaram R, Patir R. A Novel Approach to Medial Malleolus Fracture of Ankle using Adjustable Loop Suspensory Fixation. Journal of Clinical Orthopaedics July-December 2024;9(2):132-136.

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Exchange Nailing, for Atrophic Non-union of the Tibia, after Implant Breakage, Post a Non-traumatic Event

Journal of Clinical Orthopaedics | Vol 7 | Issue 2 |  Jul-Dec 2022 | page: 81-84 | Rohit Mahesh Sane, Kedar Anil Parelkar, Sunil Hiriyanna Shetty

DOI: 10.13107/jcorth.2022.v07i02.541


Author: Rohit Mahesh Sane [1], Kedar Anil Parelkar [1], Sunil Hiriyanna Shetty [1]

[1] Department of Orthopaedics, D.Y. Patil University School of Medicine, Navi Mumbai – 400706, India.

Address of Correspondence
Dr. Rohit Mahesh Sane,
Department of Orthopaedics, D.Y. Patil University School of Medicine, Navi Mumbai – 400706, India.
E-mail: dr.sanerohit@gmail.com


Abstract

Background: The most feared complication of fracture management is non-union. Non-union can be of the following types, hypertrophic, oligotrophic, atrophic, and septic. In view of a non-union, exchange nailing is preferred and so routinely performed for non-unions and fractures of the tibia.

Case Presentation: Here, we present a case of an implant failure from an atraumatic event in a case of atrophic non-union of the tibia, which was treated by exchange nailing and bone grafting. A 22-year-old male, with a history of the left closed tibia fibula diaphysis fracture 1 year ago, underwent exchange nailing with bone grating after having an atrophic non-union with implant breakage.

Conclusion: Implant failure and non-union are caused due to a wide variety of factors. Appropriate implant selection for fracture type, reaming, fracture site compression, good reduction, and adequate and early mobilization are important factors for a satisfactory union and prevention of secondary surgeries.

Keywords: Atrophic non-union, exchange nailing, implant breakage, non-traumatic event, tibia


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How to Cite this article: Sane RM, Parelkar KA, Shetty SH. Exchange Nailing, for Atrophic Non-union of the Tibia, after Implant Breakage, Post a Non-traumatic Event. Journal of Clinical Orthopaedics Jul-Dec 2022;7(2):81-84.

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