$distal tibia fibula fracture$

$distal tibia fibula fracture$

#Distal tibia fibula fracture skin

The two different devices were used for external fixation but the design of this study (multicentre and retrospective) did not provide further information about the distribution. These systems allowed early ankle and subtalar motion. This ring was connected to the frame and the system was anchored at the tibial shaft with two or three pins. Ankle sparing systems were used when technically feasible with a complete ring applied distally in the metaphyseal region with two or three wires. On average, the ankle joint was held for three weeks. Ankle spanning systems were used which comprised a unilateral frame anchored with pins at the medial border of the tibial diaphysis and at the neck of the talus and calcaneum. For other cases, limited internal fixation using 3.5-mm or 4.5-mm cannulated screws and/or K-wires through short incisions was performed in order to reduce and stabilise articular and periarticular fragments (18 cases). When indirect reduction techniques permitted a satisfactory reduction under fluoroscopy, external fixation was used alone (14 cases). Thirty-two patients were treated with external fixation. Eighteen patients had multiple injuries with visceral injuries and/or associated fractures. There were two preoperative nerve injuries and one vascular injury requiring specialised management. Open fractures were classified according to the Gustilo classification for open fractures and involved 17 patients (seven type I, eight type II and two type IIIA). We classified the distal tibia fractures according to the AO/OTA classification as type 43 (metaphyseal) with distinction of type A fractures (extra-articular), type B (partial articular) and type C (total articular) (Table 1). High-energy injury occurred in 74 cases (42 road traffic accidents and 32 falls from height) and low-energy traumatism in 27 cases (twisting injuries). Thus we obtained a group of 101 consecutive fractures (100 patients). Four subjects were lost at final follow-up and 95% of patients were reviewed for clinical and radiological evaluation. The study group included 35 women and 69 men with an average age of 44 years (range, 15–86 years).

$distal tibia fibula fracture$

This retrospective and multicentre study concerned 104 patients with 105 distal tibia fractures from 2002 to 2004 in six general hospitals in northeast France. The purpose of this paper was to study the functional and radiographic outcomes after distal tibia fractures, to evaluate complications and to determine predictive factors of poor results. ĭespite progress of surgical procedures, outcomes are not always excellent and complications affect 20–50% of patients. All of these techniques have advantages and disadvantages and there is no consensus concerning the management of these fractures. Many osteosynthesis techniques can be used for these fractures such as traditional open reduction and internal fixation (ORIF), external fixation with or without limited internal fixation, intramedullary nailing or, more recently, minimally invasive plate osteosynthesis (MIPO). The goal of orthopaedic surgeons is to restore the tibial anatomy, to fix the epi-metaphyseal block with the diaphysis and to avoid complications. Management of distal tibia fractures, with or without articular involvement, is a therapeutic challenge. For other cases, we recommend ORIF with early mobilisation.

#Distal tibia fibula fracture skin

We believe that external fixation must be reserved for trauma with severe skin injury, as a temporary solution in a two-staged protocol.

$distal tibia fibula fracture$

Predictive factors of poor results were fracture severity, complications, malunion and the use of external fixation. The average functional score was 76 points (range, 30–100 points), and complications occurred in 30 patients. Outcome parameters included occurrence of complications, radiographic analysis, evaluation of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle score and measures of the ankle range of motion. Internal fixation, external fixation, limited internal fixation (K-wires or screws), intramedullary nailing and conservative treatment were used. One hundred patients (101 fractures) were reviewed with an average follow-up of 19 months (range, 12–46). Between 20, 104 patients were admitted for 105 distal tibia fractures. In this retrospective and multicentre study we attempted to detail complications and outcomes of this type of injury in order to determine predictive factors of poor results. Distal tibia fractures are complex injuries with a high complication rate.

$distal tibia fibula fracture$