Are Malleolar Fractures Easy to Treat?

Wendsche, Peter; Dráč, Pavel

doi:10.55095/achot2012/079

Cited by 5 publications

(1 citation statement)

References 45 publications

(39 reference statements)

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“…Rovněž magnetickou rezonanci k vyšetření poranění hlezna, jak jej doporučují Seifert et al ( 30 Výhodnost CT vyšetření je dále zmiňována u zlomenin v oblasti hlezna na dospělém skeletu (2,14,36) nebo i hlezenních náhrad (27). Stejně tak je CT běžně doporučováno i u zlomenin talu (20,23,39) nebo kalkanea (38), hojně využívané je toto vyšetření i u poranění pánve (8) či páteře (31), a to někdy i peroperačně (31).…”

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Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis

Hendrych¹,

Pešl²,

Havránek³

2018

Acta Chir. orthop. Traum. Cech.

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růstovou ploténkou, a to jak v naší (11,25), tak v zahraniční (3) literatuře. TPF je charakterizována třemi na sebe kolmými liniemi lomu, frontální v metafýze ("zadní hrana"), transverzální ve fýze a sagitální v epifýze. Na rtg snímcích se schematicky jeví jako dvě samostatné zlomeninyseparace epifýzy Salter-Harris II v boční projekci, zlomenina epifýzy Salter-Harris III v AP projekci (24). ÚVODTřírovinná zlomenina distální epifýzy tibie (triplane fracture, dále jen TPF) je specifickou zlomeninou rostoucího skeletu. Popsal ji v roce 1970 Marmor (22). Nejčastěji se jedná o zlomeninu přechodného období, kdy se typickým způsobem asymetricky uzavírá distální růstová ploténka tibie (24). Byly však popsány i třírovinné zlomeniny ve věku kolem 10 let s plně funkční a otevřenou

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Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis

Hendrych¹,

Pešl²,

Havránek³

2018

Acta Chir. orthop. Traum. Cech.

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Malleolar Fractures: Guidelines and Tips for Surgical Fixation

Doral

Bilge

Huri

et al. 2019

Intraarticular Fractures

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Comparison of Plaster Fixation and Kirschner Wire Transfixation as Temporary Fixation of Displaced Ankle Fractures - Randomised Prospective Study

Zídek¹,

Urban²,

Holub³

et al. 2019

Acta Chir. orthop. Traum. Cech.

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PURPOSE OF THE STUDYThe purpose of the study was to assess two therapeutic procedures of temporary fixation of displaced ankle fractures, namely the plaster fixation or Kirschner wire (KW) transfixation via the sole of the foot. MATERIAL AND METHODS Group of patientsThe randomised prospective study conducted in the period 02/2016-02/2017 compared two methods of temporary fixation of displaced ankle fractures. In total, 38 patients were included in the study (18 patients treated with plaster fixation, 20 patients treated with KW). MethodsDuring the randomisation (by envelopes, drawing of lots by the patient), in one group of patients, temporary stabilisation by plaster fixation was performed, whereas the other group was treated by percutaneously inserted KWs. The attention was focused on the quality of achieved reduction, its retention until the final treatment, and soft tissue status. After one year, the final examination was performed, in which we focused on the assessment of the clinical condition of the ankle joint with the use of the Olerud-Molander Ankle Score (OMAS), the AOFAS (American Orthopedic Foot and Ankle Society) score, and the Visual Analogue Scale (VAS) measuring the overall satisfaction. Moreover, in both the methods potential incidence of arthritic changes was monitored on radiographs. RESULTSBoth the methods achieved 100% successful reduction rate. The group with plaster fixation reported a loss of reduction in six patients (33.3%) as against the KW group where no loss of reduction occurred. This difference was significant (p = 0.007). In plaster fixation method, after its removal local complications occurred on skin in 56%, of which skin necrosis in 16.7%, and it always occurred in association with the loss of reduction, which was statistically significant (p = 0.245). In KW method, local complications on skin were present in 25% only. In the group of patients with KW, there was not a single case of surface or deep infection reported. No KW migration was observed. DISCUSSIONPotential complications of conservative treatment of displaced fractures with plaster fixation include the migration of fragments and widening of the ankle fork during the further course which may threaten the vitality of soft tissues. A total of six patients (33.3%) treated with plaster fixation showed a failure of reduction, which is by approximately 10% more than described in literature. In seven cases after the plaster fixation removal bullae were observed (38.9%) and in three cases skin necrosis was present (16.7%), which occurred in re-displaced fractures only. The bullae were present whether the reduction was successfully maintained or not. In literature, local complications after plaster fixation removal are reported in roughly 14%. Temporary percutaneous ankle KW transfixation is applied to maintain the reduced fracture in a favourable position and to facilitate monitoring and treating the soft tissues. Prior to the final surgical solution, bullae were observed in four cases (20%), of which skin necrosis in one cas...

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Are Malleolar Fractures Easy to Treat?

Cited by 5 publications

References 45 publications

Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis

Triplane Fractures of the Distal Tibial Epiphysis - Contributions of CT Scans to Indication and Planning of Osteosynthesis

Malleolar Fractures: Guidelines and Tips for Surgical Fixation

Comparison of Plaster Fixation and Kirschner Wire Transfixation as Temporary Fixation of Displaced Ankle Fractures - Randomised Prospective Study

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