Authors: David Náhlík; Radek Hart; Tomáš Kozák; Boris Těknědžjan Authors place of work: Department of Orthopaedics and Traumatology General Hospital Znojmo ; Ortopedicko – traumatologické oddělení Nemocnice Znojmo p. o. Published in the journal: Úraz chir. 19., 2011, č.3
PURPOSE OF THE STUDY: To show the relevance and importance of the posterior edge of the tibia in treatment as the prevention of the ankle posttraumatic arthrosis and chronic tibiofibular instability.
MATERIAL AND METHODS: Prospective study was conducted in the period from June 2006 to June 2008, with the total of 48 patients with diagnosed fracture of the posterior edge of the tibia. Surgical treatment of 18 patients was performed and evaluated with Foot and Ankle Outcome Score (FAOS) as the assessment of treatment effect.
RESULTS: FAOS assessment of 18 patients with surgical treatment of the posterior edge of the tibia: 16 patients (88,9 %) received more than 90 points and 2 patients (11,1 %) 80-90 points at six months follow-up. 17 patients (94,4 %) received more than 90 points and 1 patient (5,6 %) got 80-90 points in one year after the surgical treatment. No arthrosis and no bone cysts of the posterior edge of the tibia in cases after surgical treatment were observed.
CONCLUSIONS: As prevention of the ankle posttraumatic arthrosis and chronic tibiofibular instability the restoration of the congruence of the joint surface, right lenght and axis of the fibula, the treatment of the rupture of the tibiofibular syndesmosis and the stable osteosynthesis of the posterior edge of the tibia is necessary. If the posterior edge of the tibia isn´t correctly treated, the congruence of the joint surface is disrupted and bone cysts frequently develop in this region after the union. The chronic subluxation of the fibula and talus can occur too. All these factors contribute to arthrosis development pain, movement limitation of the talocrural joint and the decrease of the patients quality of life.
Key words: ankle fracture, posterior edge of the tibia, ankle arthrosis, chronic tibiofibular instability.
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