Surgical Treatment of Distal Crural Fractures
Authors:
Pavel Kvasnička; Michal Mašek; Pavol Vojtaník
Authors‘ workplace:
Klinika Úrazové chirurgie LF MU a TC FN Brno
Published in:
Úraz chir. 20., 2012, č.4
Overview
PURPOSE:
The aim of this article is to evaluate patients data after distal tibia fracture treatment, to set up optimal algorithm of surgical therapy, and to optimize treatment strategy of injured patients.
MATERIAL AND METHODS:
Between 2008 and 2011 121 patients with distal tibia fracture were treated at the Department of Trauma Surgery, University Hospital Brno. The most common method used for the definitive treatment of distal tibia fractures was open reduction and internal fixation with LCP – locking compression plate (91 patients). Angle stable and anatomically preformed plates were used for the stabilization of distal tibia fractures. Seven fractures were stabilized by miniosteosynthesis using screws and wires. Eighteen out of 45 patients with extra-articular fractures of distal tibia were treated with intramedullary nail osteosynthesis.
RESULTS:
Detailed follow-up study included patients with intra-articular fractures of distal tibia (AO classification type B and C). Rate of wound complications and radiographic evaluation by Burwell and Charnley were assessed. Patient’s satisfaction and clinical findings were evaluated by AOFAS scoring system.
CONCLUSION:
This article informs about possibilities of surgical treatment of distal tibia fractures. It summarizes literature sources, evaluates the data of patients operated on at our department and proposes instructions how to treat these fractures. Therapeutic steps in current surgical treatment of distal tibia fractures have been clearly recommended and defined. Their maintenance significantly decreases the risk of postoperative complications. The treatment goals are anatomical reconstruction of the fracture and restoration of the injured limb function with early return of patient into the normal life activities. Due to bad results of conservative therapy, operative therapy of distal tibia fractures is preferred. Anatomically preformed plates enable to stabilize the fractures with MIPO (minimal invasive percutaneous osteosynthesis) technique. Surgical treatment of these fractures is demanding due to risk of severe complications.
KEY WORDS:
fractures of the distal tibia, plate osteosynthesis, soft tissue envelope.
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Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2012 Issue 4
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