Journal of orthopaedic trauma · 2008
Posterior fracture dislocation of the ankle: technique and clinical experience using a posteromedial surgical approach.
Клиническое исследованиеСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Bois Aaron J, Dust William
Аннотация
OBJECTIVE: The purpose of this study is to revisit the posteromedial surgical approach to the ankle and report the clinical outcomes of this technique in a cohort of 17 patients.
DESIGN: Retrospective.
SETTING: Level I trauma center.
PATIENTS: Seventeen patients between 1990 and 2006 were treated using a posteromedial surgical approach to the ankle. Thirteen presented with a posterior ankle fracture dislocation and 4 with an ankle fracture without dislocation producing a large posterior malleolar fragment. There were 6 males and 11 females, from 23 to 80 years of age (mean 45.2 years).
INTERVENTION: All but 2 patients underwent open reduction and internal fixation of the posterior malleolar fracture using a single posteromedial approach. A combined surgical approach (posteromedial and posterolateral) to the ankle was used in 2 cases.
MAIN OUTCOME MEASUREMENTS: The Foot and Ankle Outcomes Questionnaire was used to evaluate postoperative ankle pain, function, stiffness and swelling, and giving way. Posttraumatic osteoarthritis was assessed using an adapted 4-point radiographic grading system.
RESULTS: Follow-up data on 12 patients were obtained at a mean interval of 9.4 years. There were no wound complications. The average global foot and ankle score was 87 points (range 69-100). The degree of arthrosis was grades 0 in 3 ankles, I in 1 ankle, II in 5 ankles, and III in 3 ankles.
CONCLUSIONS: The posteromedial approach offers an effective technique for fracture reduction and buttress plate fixation of large posterior malleolar fragments. Good short- and mid-term clinical results should be expected.
DESIGN: Retrospective.
SETTING: Level I trauma center.
PATIENTS: Seventeen patients between 1990 and 2006 were treated using a posteromedial surgical approach to the ankle. Thirteen presented with a posterior ankle fracture dislocation and 4 with an ankle fracture without dislocation producing a large posterior malleolar fragment. There were 6 males and 11 females, from 23 to 80 years of age (mean 45.2 years).
INTERVENTION: All but 2 patients underwent open reduction and internal fixation of the posterior malleolar fracture using a single posteromedial approach. A combined surgical approach (posteromedial and posterolateral) to the ankle was used in 2 cases.
MAIN OUTCOME MEASUREMENTS: The Foot and Ankle Outcomes Questionnaire was used to evaluate postoperative ankle pain, function, stiffness and swelling, and giving way. Posttraumatic osteoarthritis was assessed using an adapted 4-point radiographic grading system.
RESULTS: Follow-up data on 12 patients were obtained at a mean interval of 9.4 years. There were no wound complications. The average global foot and ankle score was 87 points (range 69-100). The degree of arthrosis was grades 0 in 3 ankles, I in 1 ankle, II in 5 ankles, and III in 3 ankles.
CONCLUSIONS: The posteromedial approach offers an effective technique for fracture reduction and buttress plate fixation of large posterior malleolar fragments. Good short- and mid-term clinical results should be expected.