Elastic Locking Intramedullary Nails Fixation in Trimalleolar Fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Biomedical Engineering

Background:

• Open reduction and internal fixation (ORIF) for ankle fractures, common since the 1960s, presents risks like infection and hardware issues.
• Closed reduction and internal fixation (CRIF) offers biomechanical advantages with minimal incisions and low-profile hardware.

Purpose of the Study:

• To compare the efficacy of elastic locking intramedullary nails (ELIN) with rigid internal fixation (RIF) for treating trimalleolar fractures.
• To evaluate outcomes including surgical invasiveness, healing time, functional recovery, and complications.

Main Methods:

• A retrospective study of 39 patients (2020-2024) comparing ELIN and RIF groups.
• Analysis of surgical incision length, blood loss, operative time, union time, device removal time, AOFAS scores, range of motion, complications, and patient satisfaction.
• Statistical analysis using independent t-tests and Mann-Whitney U tests based on data distribution.

Main Results:

• ELIN fixation showed significantly shorter surgical incision length, less blood loss, reduced operative time, and faster union compared to RIF (p < 0.05 for all).
• No significant differences were observed in AOFAS scores, ankle dorsiflexion, or plantar flexion between the groups (p > 0.05).
• One case of ankle pain occurred in each group; one surgical site infection was noted in the RIF group.

Conclusions:

• ELIN fixation is advantageous for trimalleolar fractures, offering minimally invasive procedures, faster union, quicker device removal, improved aesthetics, and high patient satisfaction.
• ELIN provides enhanced recovery after surgery benefits and reduces risks associated with traditional intramedullary nails.
• While ELIN offers locking fixation benefits, nail removal may be more challenging compared to RIF.