FOOT & ANKLE
2013 OTA Annual Meeting: Long-Term Follow-up of High-Energy Pilon Fractures: A Prospective Comparison of Locked Plates Versus Nonlocked Plates
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2025;13(3):858 patients with high-energy pilon fractures were randomized to evaluate the efficacy of locking plates against convention nonlocking plates, over 1 year. Radiographic data was evaluated for loss of reduction using Mortise/ AP and lateral radiographs of the ankle, and functional outcomes were assessed using ankle hindfoot scores, and Short Musculoskeletal Function Assessment (SMFA). The evidence presented in this study demonstrates that both treatments perform comparably in each outcome measurement, but the authors of the study indicate that the results may suffer from type II error due to the low incidence of reduction loss.
学会報告
このACE報告は、学会発表または抄録の要約です。提供された情報により、バイアスのリスクや全体的な質の正確な評価を提供することには限界があります。臨床試験が進行中であったり、選択された結果が発表されている可能性があるため、結果を慎重に解釈してください。
なぜ今この研究が必要なのですか？
High-energy pilon fractures are conventionally treated with nonlocking plates. This study was needed to evaluate and compare the clinical and radiographic outcomes associated with the use of locking plates against nonlocking plates for the management of high-energy pilon fractures.
主な研究課題は何ですか？
Do locking plates present comparable clinical and radiographic outcomes to nonlocking plates for the treatment of high-energy pilon fractures, assessed over 1 year?
重要な知見は？
- 2 of 15 (13%) of the fractures in the nonlocking group demonstrated loss of reduction >5 degrees, compared to 3 of 19 (16%) in the lock group (p= 0.999)
- No soft-tissue complications requiring surgical intervention were observed
- 1 patient in the lock group presented with deep infection, 2 with nonunions, and 2 with hardware failures. 1 patient in the nonlock group presented with hardware failure and 1 infected nonunion
- Average follow-up in 8 patients in the lock group, and 10 in the nonlock group, was reported at 35.6 SD 16.0 months.
- No significant differences between the lock and nonlock groups for ankle hindfoot scores: 71.75 SD 71.75 versus 66.1 SD 23.8 respectively (p= 0.625)
- No significant difference between groups was apparent for SMFA-BI (bother index) scores with 7175 SD 25.4 in the lock group compared to 66.1 SD 23.8 in the nonlock group (p= 0.625)
- SMFA-FI (function index) analysis between the lock and nonlock groups revealed no significant difference with a score of 32.9 SD 36.2 in the lock group compared to 25.7 SD 20.2 in the nonlock group (p= 0.587)
最も覚えておくべきことは？
Both the locking plate and the nonlocking plates performed comparably for all evaluated outcomes: loss of reduction and radiologic analyses.
それが私の患者ケアにどのように影響するか？
The evidence presented in this study demonstrates that both locking and nonlocking plates are comparable interventions for high-energy pilon fractures. The results presented in this study may be subject to type II error as indicated by the low incidence of reduction loss.
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