Potentialities of Minimally Invasive Osteosynthesis in Treatment of Malleolus Fractures
E. I Solod , A. F Lazarev , E. G Ermolaev
N.N. Priorov Journal of Traumatology and Orthopedics ›› 2015, Vol. 22 ›› Issue (3) : 54 -59.
Potentialities of Minimally Invasive Osteosynthesis in Treatment of Malleolus Fractures
Treatment results for 71 patients with malleolus fractures are presented. In 32 patients (comparative group) surgery was performed by AO/ASIF technique after edema resolution. Thirty nine patients from the main group were operated on by our minimally invasive technique using V-shaped pins and threaded pins on the next day after admission independently on the presence of edema in the ankle joint region. All patients were operated on at terms from 1 to 3 weeks after injury. Duration of hospitalization averaged 16 and 10 days, restoration of joint function made up 6 and 2 weeks for the patients from the comparative and main group, respectively. Complications were observed only in patients from the comparative group, i.e. marginal skin necrosis in 8 (25%), inflammatory complications in 5 (15.6%), metal fixator migration in 1 (3.1%) and fracture nonunion in 4 (12.5%) patients. Outcomes were assessed by AOFAS Ankle- Hindfoot Scale. Mean point made up 90.3 in the main group and 88.6 in the comparative jnt. In the experimental part of the study the strength (tensile and shear) of 3 types of osteosynthesis for medial malleolus fracture were compared: with either 2 cannulated screws, V-shaped pin or 2 biodegradable screws of glycolized lactic acid was compared. Although the osteosynthesis of medial malleolus with V-shaped pin was the least strong it met the requirements of internal osteosynthesis.
fractures / minimally invasive interventions / percutaneous / osteosynthesis / ankle joint / malleoli / pins
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