Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Jun 2006
Clinical Trial[Intramedullary locked fixation and compression nail (IP-XS-Nail): treatment of ankle joint fractures].
Reconstruction of the anatomy of the ankle joint while protecting the soft tissue, and osteosynthesis to maintain stability for function and weight bearing. ⋯ In the period from 05/2000 to 01/2002, 194 ankle fractures were treated with the IP-XS-Nail((R)). Follow-up examinations were conducted on 162 patients with an average age of 51.2 years after an average of 15 months. 62 Weber B fractures (38.3%) and 45 Weber C fractures (27.7%) were evaluated. There were bimalleolar fractures in 55 cases (34.0%). According to the Olerud Score (clinical and radiologic score), 95 patients (58.6%) had an excellent, 54 (33.3%) a good, nine (5.5%) a moderate, and four (2.4%) an unsatisfactory result.
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Restoration of the intra- and extraarticular anatomy of the distal radius. Stable internal fixation of fragments, with the possibility of early functional rehabilitation. ⋯ 25 consecutive patients were monitored following a double-plate fixation, with a minimum follow-up of 12 months. In all cases the reduction, in accordance with the Stewart Score, was very good, a loss of reduction was not observed. The range of motion was between 100 degrees and 160 degrees for flexion/extension and between 160 degrees und 180 degrees for pronation/supination. The average DASH Score was 7.2 points, the PRWE Score 8.0 points. No relevant loss of strength (JAMAR dynamometer) was found in any of the patients in comparison with the healthy side. Complications noted were a muscle adhesion in the region of the first extensor compartment as well as a mild reflex sympathetic dystrophy, which healed without consequences. Implants were removed from six of the patients.
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Oper Orthop Traumatol · Oct 2005
Case Reports[Primary Ilizarov ankle fusion for nonreconstructable tibial plafond fractures].
Ankle arthrodesis in a plantigrade position. In high-energy open injuries with segmental bone loss: proximal tibial metaphyseal corticotomy with distal Ilizarov bone transport for compensation of leg length discrepancy. ⋯ Between January 1993 and September 1996, four patients (two men, two women) with severe, nonreconstructable fractures of the tibial plafond were treated. Callus distraction and Ilizarov bone transport in three patients. Age range 19-68 years (average age 45.7 years). Mean follow-up 6.6 years (4 years 9 months to 7 years 4 months). Average duration of the entire treatment in external fixation 54.4 days/cm for the three bone distraction patients. Mean transport 6 cm (4.5-8.5 cm). One patient required repeat ankle arthrodesis.
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Bony fusion between tibia and talus in neutral position of foot. Return to a pain-free function of the lower limb. ⋯ 20 arthrodeses in 19 patients were followed up for an average of 39 months (12-69 months). All arthrodeses were fused. In one patient a fibular pseudarthrosis was encountered. All arthrodeses healed in a correct position but one that consolidated with a pes equinus of 3 degrees . The average AOFAS (American Orthopedic Foot and Ankle Society) hindfoot score reached 78.5 points (40-86 points). A marked reduction of symptoms and satisfactory function were reported postoperatively by all patients. All would be willing to undergo surgery again.
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Arthrodesis of the ankle at 90 degrees and perfect axial alignment for restoration of a painless function. Early functional postoperative care. ⋯ Between January 1, 1994 and December 31, 1998 this technique was performed in 50 ankles of 48 patients. 40 patients could be followed up for an average of 5.6 years (4.8-7.6 years). No serious complications. The average compensatory movement of the Chopart joint amounted to 26 degrees . Osteoarthritis of the subtalar joint was seen in 13%, and of the talonavicular joint in 12.5% of patients. Preexisting osteoarthritis of these joints remained in general unchanged. The AOFAS Score was assessed pre- and postoperatively. Preoperatively, 17.5% of patients showed a satisfactory and 82.5% a poor score. Postoperatively, 52.5% had an excellent, 30% a good, 10% a satisfactory, and 7.5% a poor outcome.