Application of Nice knot assisted reduction technique and traditional reduction technique in displaced comminuted lateral malleolar fractures

Objective To compare the efficacy of Nice node assisted reduction technique (Nice node fixation) and traditional reduction technique (screw fixation) in displaced comminuted lateral malleolar fractures.

Methods The data of 105 adult patients with comminuted lateral ankle fracture (C type of Danis-Weber type) were retrospectively analyzed.According to different treatment methods, they were divided into Nice node group (Nice node-assisted reduction technique, n=53) and traditional group(traditional reduction technique, n=52). Operative time, intraoperative blood loss, fracture healing time, Visual Analogue Scale (VAS) score on the second day after surgery, American Orthopedic Foot Andankle Society (AOFAS) score at last follow-up and postoperative complications (internal fixation failure, infection, bone mass displacement and bone nonunion) were recorded and compared between the two groups.

Results All the 105 patients successfully completed the operation, and the follow-up time was 6 to 15 months, with an average of (10.7±3.5) months. The operative time, fracture healing time and intraoperative blood loss in Nice node group were significantly shorter or less than those in the traditional group (P < 0.05). There was no significant difference in VAS score and ankle AOFAS score at the last follow-up between the two groups (P>0.05). There were no postoperative complications in the Nice node group, and 3 cases of fracture mass displacement occurred in the traditional group.

Conclusion The effect of Nice junction assisted reduction technique in the treatment of displaced lateral malleolar comminuted fracture is better than that of traditional screw reduction technique, which is simple to operate, short in operation time, and has less intraoperative blood loss and good postoperative effect.