Calcaneal distraction vs. cast immobilization for the preoperative treatment of patients with Danis-Weber type C ankle fractures: a case-control study

• Published in: Frontiers in surgery 2024-07, Vol.11, p.1404746
• Main Authors: Song, Bing, Shi, Jisheng, Xu, Xiaohui, Hou, Xiangfeng, Jia, Jingkun, Pang, Tongtao
• Format: Article
• Language: English
• Subjects: ankle fracture; calcaneal distraction; cast immobilization; Danis–Weber type C ankle fractures; Surgery; temporizing fixation
• ISSN: 2296-875X; 2296-875X
• DOI: 10.3389/fsurg.2024.1404746

Ankle fractures require temporary fixation to allow swelling to subside prior to surgery; this is typically achieved using calcaneal distraction or cast immobilization. We compared the results of these methods in the treatment of Danis-Weber type C ankle fractures. This retrospective study analyzed the data of 86 patients with Danis-Weber type C ankle fractures, of whom 40 underwent calcaneal distraction and 46 underwent cast immobilization. Clinical measures including preoperative detumescence time, daily swelling value, skin condition, and pain, SF-36 Health Survey (SF-36) score and ankle scores were compared between the two groups. Baseline characteristics did not differ significantly between the groups. Calcaneal distraction resulted in a lower preoperative detumescence time (6.22 ± 0.64 vs. 8.94 ± 0.82 days) and lower daily swelling values compared with cast immobilization, leading to a lower skin necrosis rate. Resting pain scores were significantly lower in the calcaneal distraction group than in the cast immobilization group at various postoperative time points (