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Treatment of intraarticular distal tibial fractures by external fixation


Authors: Radek Veselý;  Radomír Suchomel;  Libor Paša;  Ivan Melichar;  Ján Kužma
Authors‘ workplace: Traumatological hospital Brno ;  Úrazová nemocnice v Brně
Published in: Úraz chir. 21., 2013, č.2

Overview

OBJECTIVE:
A retrospective clinical study evaluate two types of external fixation in high energy injury of distal tibial fractures treated in Traumatological hospital Brno on Clinic of Trauma Surgery, Medical Faculty Masaryk University Brno. Authors evaluate duration of the fracture healing process and the incidence of complications.

MATERIAL AND METHODS:
The patients with distal tibial fractures type C2 and C3 according to AO classification were treated by two types of external fixation - ankle spanning and ankle sparing fixation. Clinical evaluation was achieved by Weber´s protocol.

RESULTS:
Authors present a study involving 34 patients. All fractures healed. The average time of fixation was 14 weeks. Pin tract infect were occurred in 13 patients and deep infection in two patients. In closed fracture with ankle sparing fixation were 69 % patients with excelent and good results according to Weber´s protocol. In closed fractures with ankle spanning fixation were 61 % patients. In open fractures group were excelent and good results in patients with ankle sparing fixation in 58 % and in ankle spanning fixation in 53 %. Delayed union were observed in 4 patients and enforced spongioplasty. In two cases were necessary performed medial plate stabilisation.

CONCLUSION:
Our study confirmed good results in treatment high energy distal tibial fractures by ankle sparing external fixation. The benefits of this type of external fixation were low incidence of complications and early movement of ankle. The application of external fixation is safety method appropriate for treatment of intraarticular distal tibial fractures and open fractures.

Key words:
external fixation, distal tibial fracture.


Sources

1. HUGHES, JL., WEBER, H., WILLENEGGER, H., et al. Evaluation of Ankle Fractures: Non-Operative and Operative Treatment. Clin Orthop. 1979, 138, 111–119.

2. OCKU, G., AKTUGLU, K. Intraaticular fractures of the tibial plafond. A comparison of the results using articulated and ring external fixators. J Bone Jt Surg Br. 2004, 86B, 868–875.

3. OVADIA, DN., BEALS, RK. Fractures of the tibial plafond. J Bone Jt Surg Am. 1986, 68, 543–551.

4. RUEDI, TP., ALLGOWER, M. Fractures of the lower end of the tibia into the ankle-joint. Injury. 1969, 1, 92–99.

5. RUKAVINA, A. The role of fibular length and the width of the ankle mortise in post-traumatic osteoarthrosis after malleolar fracture. Int Orthop. 1998, 22, 357–360.

6. SIRKIN, M., SANDERS, R., DIPASQUALE, T., Jr., et al. A staged protocol for soft tissue management in the treatment of complex pilon fractures. J Orthop Trauma. 1999, 13 , 78–84.

7. VESELÝ, R., PROCHÁZKA, V., VIŠŇA, P., et al. Tibiotalokalkaneální artrodéza nitrodřeňovým hřebem jištěným v sagitální rovině. Acta Chir orthop Traumatol Czech. 2008, 75, 129–133.

8. WILLIAMS, TM., MARSH, JL., NEPOLA, JV., et al. External fixation of tibial plafond fractures: Is routine plating of the fibula necessary? J Orth Trauma. 1998, 12, 16–20.

9. WYRSCH, B., MCFERRAN, MA., MCANDREW, M, et al. Operative treatment of fractures of the tibial plafond: A randomized, prospective study. J Bone Jt Surg Am.1996, 78, 1646–1657.

10. ZEMAN, J., MATĚJKA, J. Use of a hybrid external fixator for treatment of tibial fractures. Acta Chir orthop Traumatol Czech. 2005, 72, 337–343.

Labels
Surgery Traumatology Trauma surgery
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