[Treatment of luxation fractures of the talocrural joint].

Authors have analysed some characteristics of the functional anatomy, biomechanics, classification and treatment of fractures of the talocrural joint with special emphasis of sprained fractures. Based on data from different references, as well as on the authors' experience, they came to the conclusion that a great percentage of these fractures heal with shortening of the fibula; the latter causes disorders of the biomechanical mechanism in this joint. The importance of the fibula especially in the statics and the dynamics of the lower limb has been stressed out, as well as the possibility of precise measurement of posttraumatic shortening of the fibula. The treatment of the fractures of talocrural joint should be individual, bearing in mind that in most cases only meticulous surgical reposition of the ligaments does give a correct anatomical relations between the joints bodies and a normal function of the joint itself. By conservative measures and external immobilisation with plaster, it is not possible to avoid dislocation of the fragments when fractures of type C happens, or most of the fractures of Type B, and a few of type A--Weber's classification. The conservative treatment is recommended only with those fractures of the types A and B, where clinically or by x-ray the fragments being impacted, without any dislocation between them, and without lesions of tibio-fibular syndesmosis and collateral ligaments. For all other sprained fractures there is always an indication for surgical correction.