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Int Orthop. 2009 Aug;33(4):1135-9. doi: 10.1007/s00264-008-0617-9. Epub 2008 Jul 11.

Lateral fixation of open AO type-B2 ankle fractures: the Knowles pin versus plate.

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Department of Orthopedic Surgery, Lin Shin Hospital, No. 36, Huizhong Rd., Nanton District, Taichung City, 408, Taiwan.


Forty-seven patients with open lateral malleolar (AO type-B2) fractures treated with copious irrigation and radical debridement, reduction, and immediate fixation by Knowles pins or lateral plates were retrospectively reviewed with an average follow-up period of 29 months. The 47 patients were divided into two groups, based on the method of treatment. The Knowles pin group included 25 patients. The plate group included 22 patients. There was no difference between the Knowles pinning and lateral plating with respect to the rate of good reduction (96% vs. 95.5%, p = 1). Both of the groups were similar in good and excellent results (92% vs. 86.4%, p = 0.65). However, Knowles pinning had significantly shorter operation time, smaller wound size, less symptomatic hardware, and lower complication rate than lateral plating (all p values <0.04). In conclusion, lateral fixation of open AO type-B2 ankle fractures by the Knowles pin is recommended due to its efficacy, simplicity, and low complication rate.

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