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A study on surgical treatment of ankle fractures- A clinical study of 21 cases

机译:踝部骨折的手术治疗研究-附21例临床研究

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Background : Ankle fractures are the most common significant lower extremity fractures. These fractures gain importance because the whole body weight is transmitted through the ankle, and locomotion depends on the stability of the ankle. Open reduction and internal fixation have become the main stay of treatment for most of the ankle fractures, As these operative methods restores the anatomy, biomechanics and contact loading characteristics of the ankle. Materials & Methods : The results from a consecutive series of 21 patients followed for an average period of 6 months? between November2010- June 2012 that were classified according to Lauge-Hansens classification and treated according to the AO system are presented. Assessment of the outcome was done using the scoring system of Baird and Jackson which is based on subjective objective and radiological criteria. Results : Out of 21 patients treated, overall good to excellent results were obtained in 17 patients. The results were fair in three and poor in one patient . There were no intra operative complications. The postoperative complications were skin infection in two patients. Conclusions : Anatomical reduction is essential in all intra articular fractures, more so if a weight bearing joint like ankle is involved. Open reduction and internal fixation guarantee high standard of reduction besides eliminating chances of loss of reduction. The fibular length has to be maintained for lateral stability of the ankle. Chances of non union of the medial malleolus due to periosteal interposition are avoided. Poor clinical results are found to be associated with unsatisfactory surgical reduction.
机译:背景:踝部骨折是最常见的重大下肢骨折。这些骨折变得非常重要,因为整个体重都通过脚踝传递,并且运动取决于脚踝的稳定性。切开复位术和内固定术已成为大多数踝关节骨折的主要治疗手段,因为这些手术方法可恢复踝关节的解剖结构,生物力学和接触负荷特性。材料与方法:连续21例患者的结果平均随访6个月?提出了在2010年11月至2012年6月之间根据Lauge-Hansens分类进行分类并根据AO系统进行处理的方法。使用贝尔德和杰克逊的评分系统对结果进行评估,该评分系统基于主观客观和放射学标准。结果:在接受治疗的21例患者中,有17例获得了总体良好至优异的结果。结果3例相当,1例差。术中无并发症。术后并发症为两名患者的皮肤感染。结论:在所有关节内骨折中,解剖复位是必不可少的,如果涉及到像踝关节这样的负重关节,则更是如此。切开复位和内固定可确保高标准的复位,同时消除了复位损失的机会。必须保持腓骨长度,以确保脚踝的横向稳定性。避免由于骨膜插入而使内踝不愈合的可能性。发现不良的临床结果与手术切除率不理想有关。

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