title: Single hemicerclage for lateral type B malleolar fracture--a novel, minimal and reliable osteosynthesis.
abstract: OBJECTIVE
  To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord.
  
  
  METHODS
  Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls.
  
  
  RESULTS
  The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord.
  
  
  CONCLUSIONS
  The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.
authors.affiliation: Surgical Clinic, Hospital of Liestal, Liestal, Switzerland. christoph.maurer@ksli.ch
authors.forename: C A
authors.initials: CA
authors.lastname: Maurer
authors.forename: I
authors.initials: I
authors.lastname: Stamenic
authors.forename: R
authors.initials: R
authors.lastname: Stouthandel
authors.forename: J
authors.initials: J
authors.lastname: Ackermann
authors.forename: H R
authors.initials: HR
authors.lastname: Gonzenbach
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001864:Bone Wires; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D016687:Polydioxanone; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D011859:Radiography; D013537:Sutures
chemical_list: D016687:Polydioxanone