METHOD FOR OPEN REPOSITION AND OSTEOSYNTHESIS OF LOWER LEG DISTAL SEGMENT FRACTURES

摘要

FIELD: medicine.;SUBSTANCE: during open reposition and osteosynthesis of lower leg distal bones fractures, combined osteosynthesis is applied using an external fixation device and plate-like metal detectors. Osteosynthesis is carried out in two stages. At the first stage, needles are directed through the middle of the heel bone from inside outwards at an angle of 15 degrees to the frontal plane of the ankle, then the needles not more than 2 mm in diameter are directed at the level of tibia tuberosity perpendicularly to the tibia sagittal axis, the external fixation device is assembled. At the second stage, open reposition and extramedullary osteosynthesis are performed under the conditions of distraction osteosynthesis. To do this, access is made along the back surface of the ankle and the lower third of the tibia, incision of skin and soft tissues is performed in parallel to the fibula, between the mid distance from the lattter and the Achilles tendon. The fibula length is restored, its temporary fixation is performed by needles. The final stabilisation of the fibula fracture is carried out with a bone metal fixator. The tibia fracture is exposed, repositioned and temporaryly fixed by needles. After an adequate level of fracture repositioning and congruence restoration in the ankle joint are obtained, the tibia fracture is stabilised by a extramedullary metal fixator, which is located on the posterior surface of the tibia. The needles are removed, the wound is sutured, using visual and EOC control.;EFFECT: method allows to achieve complete anatomical repositioning and stable fixation of bone fragments, to perform osteosynthesis of both shin bones from one access and to hide the metal fixators with a sufficient volume of soft tissues, so that prevention of necrosis and infectious and inflammatory complications, restoration of painless movements in the ankle joint are provided in the near postoperative period .;2 cl, 3 dwg, 1 ex