Posterior malleolar fractures of the ankle
| Autor: | Jan Bartoníček, Ondřej Naňka, Michal Tuček, Stefan Rammelt |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Joint Instability
medicine.medical_specialty Sports medicine medicine.medical_treatment Bone Screws Joint Dislocations Critical Care and Intensive Care Medicine Ankle Fractures Fixation (surgical) Fracture Fixation Internal Imaging Three-Dimensional Postoperative Complications Ct examination medicine.ligament medicine Internal fixation Humans Orthopedics and Sports Medicine Surgical treatment business.industry Surgery Biomechanical Phenomena medicine.anatomical_structure Treatment Outcome Posterior tibiofibular ligament Ligaments Articular Emergency Medicine Distal fibula Radiology Ankle business Tomography X-Ray Computed Bone Wires |
| Zdroj: | European journal of trauma and emergency surgery : official publication of the European Trauma Society. 41(6) |
| ISSN: | 1863-9941 |
| Popis: | Despite an increasing awareness of injuries to PM in ankle fracture-dislocations, there are still many open questions. The mere presence of a posterior fragment leads to significantly poorer outcomes. Adequate diagnosis, classification and treatment require preoperative CT examination, preferably with 3D reconstructions. The indication for surgical treatment is made individually on the basis of comprehensive assessment of the three-dimensional outline of the PM fracture and all associated injuries to the ankle including syndesmotic instability. Anatomic fixation of the avulsed posterior tibiofibular ligament will contribute to syndesmotic stability and restore the integrity of the incisura tibiae thus facilitating anatomic reduction of the distal fibula. A necessary prerequisite is mastering of posterolateral and posteromedial approaches and the technique of direct reduction and internal fixation. Further clinical studies with higher numbers of patients treated by similar methods and evaluation of pre- and postoperative CT scans will be necessary to determine reliable prognostic factors associated with certain types of PM fractures and associated injuries to the ankle. |
| Databáze: | OpenAIRE |
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