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Transitional ankle fracture management using a new joystick technique

  • Yuancheng Pan
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou 350007, China

    Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma, Fuzhou 350007, China

    Fuzhou Trauma Medical Center, Fuzhou 350007, China.

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
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  • Xinzhao Zhang
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
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  • Zhibin Ouyang
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
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  • Song Chen
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
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  • Ran Lin
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
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  • Yueming Guo
    Affiliations
    Department of Orthopedics, Foshan Hospital of Traditional Chinese Medicine, Foshan 528000, China
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  • Shunyou Chen
    Correspondence
    Corresponding author.
    Affiliations
    Department of Orthopedics, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, The Third Clinical Medical College, Fujian Medical University, Fuzhou Second Hospital, Fuzhou 350007, China

    Department of Orthopedics, Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou 350007, China

    Fujian Provincial Clinical Medical Research Center for First Aid and Rehabilitation in Orthopaedic Trauma, Fuzhou 350007, China

    Fuzhou Trauma Medical Center, Fuzhou 350007, China.

    Fuzhou Key Clinical Specialty, Fuzhou 350007, China
    Search for articles by this author

      Highlights

      • Adolescent transitional ankle fracture is a specific type of fracture that occurs during the adolescent growth phase.
      • Arthrography is an important surgical method in pediatric orthopedic surgery.
      • In order to improve the success rate of closed reduction, we use the joystick technique to transitional ankle fracture.
      • The arthrography-assisted joystick technique provide an important guidance to transitional ankle fracture.

      Abstract

      Purpose

      To investigate the feasibility and short-term clinical efficacy of the arthrography-assisted joystick technique for the treatment of adolescent transitional ankle fracture.

      Methods

      A retrospective analysis was performed in 10 adolescent transitional ankle fracture patients treated with the arthrography-assisted joystick technology. There were 7 male patients and 3 female patients with a mean age of 12.80 ± 1.81 years (range: 10–16 years). All cases were closed fractures, and the operation was performed after the failure of manual reduction [X-ray or computed tomography (CT) showed that the fracture gap was > 2 mm]. After the operation, X-ray or CT examination was performed to assess reduction of the fracture. Ankle function and fracture healing were evaluated by assessing the imaging indexes and evaluating the American Orthopedic Foot and Ankle Society (AOFAS) ankle score system.

      Results

      All patients were followed up for an average period of 12.00 ± 3.40 months (range: 8–20 months). The operation time was 40.50 ± 16.90 min (range: 25–80 min), the number of intraoperative fluoroscopy sessions was 18.70 ± 5.91 (range: 10–30 sessions), and the intraoperative blood loss was 5.90 ± 3.38 ml (range: 2–10 ml). X-ray examination showed that all cases achieved bone healing. The fracture healing time was 11.00 ± 2.45 weeks (range: 8–16 weeks). Four cases showed early closure of the epiphysis. The AOFAS scoring system evaluation results of these 10 pediatric cases were excellent.

      Conclusion

      The arthrography-assisted joystick technique for the treatment of adolescent transitional ankle fracture offers advantages, such as minimal trauma, simple operation, ideal reduction effect, and the recent curative effect is satisfactory.

      Keywords

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      References

        • Devries C
        • Meyer Z
        • Abzug JM
        • Baldwin KD
        • Milbrandt TA
        • Hosseinzadeh P.
        Pediatric ankle fractures: when to operate and when to leave alone ?.
        Instr Course Lect. 2019; 68: 481-488
        • Cuzmar-Grimalt D
        • Escudero-Heldt M
        • Aldunate-González JT
        • Plaza-Guzmán N
        Fractura de tobillo en adolescentes: fractura triplanar de tobillo asociada a fractura de pierna [Ankle fracture in adolescents: triplanar injury associated to fracture of leg].
        Acta Ortop Mex. May-Jun 2016; 30: 144-146
        • Blackburn EW
        • Aronsson DD
        • Rubright JH
        • Lisle JW.
        Ankle fractures in children.
        J Bone Joint Surg. 2012; 94: 1234-1244
        • Su AW
        • Larson AN.
        Pediatric ankle fractures: concepts and treatment principles.
        Foot Ankle Clin. 2015; 20: 705-719
        • Denning JR.
        Complications of pediatric foot and ankle fractures.
        Orthop Clin North Am. Jan 2017; 48: 59-70
        • Novais E N
        • Andrade M A P
        • Gomes D C
        The use of a joystick technique facilitates closed reduction and percutaneous fixation of multidirectionally unstable supracondylar humeral fractures in children.
        J Pediatric Orthop. 2013; 33: 14-19
        • Nowicki P D
        • Duhn R
        The use of arthrography in pediatric orthopaedic surgery.
        JAAOS. 2014; 22: 472-481
        • Ala-Ketola L
        • Keski-Nisula L
        • Haapanen A.
        Ankle arthrography in acute injuries.
        Ann Clin Res. 1984; 16: 10-13
        • Olson RW.
        Ankle arthrography.
        Radiol Clin North Am. Jun 1981; 19: 255-268
        • Kitaoka HB
        • Alexander IJ
        • Adelaar RS
        • Nunley JA
        • Myerson MS
        • Sanders M.
        Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes.
        Foot & ankle international. 1994; 15: 349-353
        • Sabharwal S
        • Zhao C
        • Edgar M
        Lower limb alignment in children: reference values based on a full-length standing radiograph.
        J Pediatr Orthop. 2008; 28: 740-746
        • Schneidmueller D
        • von Rüden C
        • Friederichs J
        • Bühren V.
        Übergangsfraktur: Epiphysenverletzungen im Adoleszentenalter [Transitional fractures: epiphyseal injuries in adolescence].
        Unfallchirurg. Jun 2016; 119: 517-526
        • Crawford AH.
        Triplane and Tillaux fractures: is a 2 mm residual gap acceptable?.
        J Pediatr Orthop. Jun 2012; 32: S69-S73
        • Schneider FJ
        • Linhart WE.
        Posttraumatische Komplikationen am kindlichen Sprunggelenk [Posttraumatic complications after pediatric ankle injuries].
        Orthopade. Aug 2013; 42 (quiz 677-8): 665-676
        • Lurie B
        • Van Rysselberghe N
        • Pennock AT
        • Upasani VV.
        Functional outcomes of tillaux and triplane fractures with 2 to 5 millimeters of intra-articular gap.
        J Bone Joint Surg Am. 2020 Apr 15; 102: 679-686
        • Endele D
        • Jung C
        • Bauer G
        • Mauch F.
        Value of MRI in diagnosing injuries after ankle sprains in children.
        Foot Ankle Int. 2012; 33: 1063-1068
        • Trnka HJ
        • Ivanic G
        • Trattnig S.
        Arthrography of the foot and ankle. Ankle and subtalar joint.
        Foot Ankle Clin. 2000 Mar, 5; : 49-62
        • Cass JR
        • Peterson HA.
        Salter-Harris Type-IV injuries of the distal tibial epiphyseal growth plate, with emphasis on those involving the medial malleolus.
        J Bone Joint Surg Am. Oct 1983; 65: 1059-1070
        • Gönç U
        • Kayaalp A.
        Cocukluk ve ergenlik döneminde ayak bileği kiriklari [Ankle fractures in children and adolescents].
        Acta Orthop Traumatol Turc. 2004; 38: 127-137