$cpt code for closed treatment of lateral malleolus fracture$

Ankle fractures involving the medial malleolus showed a higher incidence of lateral malleolar pseudoarthrosis (0.7 %) than fractures which did not involve the medial side (0.1 %). In combined tibia/fibula fractures, fibular nonunion occurred more commonly when the tibia was stabilised with intramedullary nails (5.5 % in the nail group, 4.14 % in the plate group, and none in the conservative group). The range of follow-up (from three months to 23 years) was reported in eight articles only. The age range was from ten years to 72 years. In the five articles which reported the gender of patients, the male to female ratio was 2.9:1. A total of 119 fibular nonunion cases were reported, of which 69 (57.9 %) were part of a rotational ankle fracture, 49 (41.2 %) accompanied fracture of the tibial shaft and one (0.8 %) nonunion followed fibular osteotomy (Table 1). The overall incidence varies from 0.3 % to 5.4 %.

$cpt code for closed treatment of lateral malleolus fracture$

It has been reported to occur either as a part of ankle fracture or in combination with fractures of the tibia (Fig. There is very little evidence on true incidence of isolated fibular nonunion. Six articles and five single case reports which dealt with the paediatric population were excluded. Twelve articles were included in this systematic review. Twenty-three articles describing fibular nonunion/delayed union or pseudoarthrosis were reviewed. Eighteen other articles were excluded because 12 were determined to be unrelated case reports (e.g., paediatric fractures, paediatric pseudoarthrosis, etc.) and six were on ankle/fibular malunion. There were 21 articles on biomechanical studies. Thirty-eight articles were on unrelated topics on basic science research. Sixty articles described nonunion of other bones. Seventy-six articles were excluded because the index procedures and cause of the nonunion was a fibular strut graft used for another nonunion site.

$cpt code for closed treatment of lateral malleolus fracture$

The reference review of all articles contributed four additional studies complying with our eligibility criteria. Although the Ovid Medline search yielded 7,948 results, it did not show any additional studies meeting our eligibility criteria. The PubMed MeSH search yielded 236 results (Fig.

$cpt code for closed treatment of lateral malleolus fracture$

We focussed on the incidence, risk factors, evaluation and treatment modalities for fibular nonunions as evident in the current literature and have proposed a treatment algorithm. The purpose of this systematic review was to analyse the available evidence regarding nonunions of the fibula. Although recent evidence suggests that the incidence of nonunion of the fibula has risen with the interlocking intramedullary nailing of the tibia, there is a scarcity of information on delayed union or nonunion of fibula in conjunction with a concomitant tibial fracture.Īlthough the nonunion of the medial malleolus has been a subject of a fair number of articles, ununited fractures of the lateral malleolus (fibular nonunions) have been generally regarded as a complication of little or no significance. Most of these fractures heal without consequences some do not heal and go on to become non-unions. The fibula is fractured in 75–85 % of cases with fractures of the tibia.

$cpt code for closed treatment of lateral malleolus fracture$

The true incidence of the nonunion of the fibula (lateral malleolar fracture in conjunction with ankle injury and fibula fracture in conjunction with a tibial shaft fracture) is difficult to determine because most remain asymptomatic and, therefore, unrecorded. Fibular fracture may occur in conjunction with fractures of the tibia or as a component of malleolar fracture of the ankle.

$cpt code for closed treatment of lateral malleolus fracture$

Cpt code for closed treatment of lateral malleolus fracture