The use of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia
Keywords:tibia, trans-syndesmotic fractures, surgical treatment, stable-elastic fixation
The problem of complications and the frequency of poor outcomes in the surgical treatment of ankle fractures with ti-biofibular syndesmosis (TFS) rupture (4.8–36.8 % of cases) remains
significant. It was interesting from a scientific and practical point of view to conduct a clinical study to determine the effectiveness of the newly developed method of metal osteosynthesis for tibial fractures with TFS rupture, which would combine stability of tibial fixation and not limit the elastic qualities of TFS. The aim of the study: to determine the effectiveness of combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia. Materials and methods. On the basis of own clinical researches and data of literature sources, the method of the combined stable-elastic fixation for unstable injuries of the ankle joint in trans-syndesmotic fractures of the tibia is developed. The effectiveness of the proposed technique was evaluated 6 months after surgery on the Kitaoka scale. We have examined 12 patients with tibial fractures type 44 B1, B2 and B3 according to the AO classification, who underwent surgery using our methods. Results. The high efficiency of using the technique of combined stable-elastic fixation for unstable injuries of the ankle joint due to trans-syndesmotic fractures of the tibia has been determined. Good and excellent treatment results 6 months after surgery were observed in all 12 people (100 %), with excellent outcomes observed in 75 % of cases. There were no satisfactory and unsatisfactory treatment results. Conclusions. The study proves the high efficiency of the proposed method for combined stable-elastic fixation of ankle injuries in unstable trans-syndesmotic fractures of the tibia with TFS damage. There were 75 % excellent and 25 % good results within 6 months after surgery. A wider introduction of this technique into the practice of traumatologists of Ukraine is proposed.
Bartoníček J., Rammelt S., Tuček M., Naňka O. Posterior malleolar fractures of the ankle. Eur. J. Trauma Emerg. Surg. 2015. Vol. 41. № 6. P. 587-600. doi: 10.1007/s00068-015-0560-6.
Dattani R., Patnaik S., Kantak A., Srikanth B., Selvan T. Injuries to the tibiofibular syndesmosis. The Journal of Bone and Joint Surgery. British. 2008. Vol. 90. № 4. Р. 405-410. doi: 10.1302/0301-620X.90B4.19750.
Мыцыков М.Ю. Хирургическое лечение больных с повреждением дистального межберцового синдесмоза (экспериментально-клиническое исследование): Автореф. дис... канд. мед. наук. Саратов, 2010. 25 с.
Haller J.M., Githens M., Rothberg D., Higgins T., Barei D., Nork S. Syndesmosis and Syndesmotic Equivalent Injuries in Tibial Plafond Fractures. J. Orthop. Trauma.
Vol. 33. № 3. P. 74-78. doi: 10.1097/BOT.0000000000001363.
Горбатов Р.О. Современное оперативное лечение переломов лодыжек и их последствий (обзор). Современные технологии в медицине. 2015. Т. 7. № 2. С. 153-167. doi: 10.17691/sim2015.7.2.20.
Viberg B., Kleven S., Hamborg-Petersen E., Skov O. Complications and functional outcome after fixation of distal tibia fractures with locking plate — A multicentre study. Injury. 2016. Vol. 47. № 7. P. 1514-1518. doi: doi.org/10.1016/j.injury.2016.04.025.
Juto H. Epidemiology of Adult Ankle Fractures: 1756 cases identified in Norrbotten County during 2009-2013 and classified according to AO/OTA. BMC Musculoskelet Disord. 2018. Vol. 13. № 19(1). P. 441. doi: 10.1186/s12891-018-2326-x.
Gougoulias N., Khanna A., Sakellariou A., Maffulli N. Supination-External Rotation Ankle Fractures: Stability a Key Issue. Clinical Orthopaedics and Related Research. 2009. Vol. 468. № 1. Р. 243-251. doi: 10.1007/s11999-009-0988-2.
Buckley R.E. et al. AO principles of fracture management. 3rd ed. Thieme. 2018. 1120 р. doi: 10.1055/b-0038-160811.
Kitaoka H. Clinical rating systems for the ankle — hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int. 1994. Vol. 15. № 7. P. 349-353. doi: 10.1177/107110079701800315.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.