Deszczyński Jarosław, Szczesny Grzegorz, Karpiński Janusz, Deszczyńska Helena, Ziółkowski Marcin
Klinika Ortopedii i Rehabilitacji, II Wydział Lekarski, Akademia Medyczna w Warszawie.
Chir Narzadow Ruchu Ortop Pol. 2002;67(3):269-77.
Massive ankle fractures lead to joint stiffness and resulting decrease in range of motion. This can be avoided by functional treatment. In cases where severe soft tissue trauma coexists with bone fractures surgical treatment is limited and external fixation is the method of choice. Modern external fixation technique allows for stabilisation and maintaining range of motion in the affected joint. This paper presents the results of application of the Dynastab-S external fixator. The construction of this fixator allows dorsal and plantar, reducing postraumatic joint stiffness. It also allows appropriate insight into soft tissues and debridement of devitalised tissues as well as their forthcoming surgical reconstruction. In our material (27 cases) treated with the Dynastab-S fixator for an average of 16 weeks a satisfactory bone healing process in all cases was noted. Appropriate function of the extremity was maintained, with comparable plantar flexion to the contralateral, not affected joint. Only in one case post operative treatment was complicated by algodystrophy. Our observations showed that implementation of modern external stabilisation techniques leads to appropriate fracture healing with full function of the inferior extremity.
严重的踝关节骨折会导致关节僵硬,进而使活动范围减小。通过功能治疗可以避免这种情况。在严重软组织创伤与骨折并存的病例中,手术治疗受限,外固定是首选方法。现代外固定技术能够实现受影响关节的稳定并保持其活动范围。本文介绍了Dynastab - S外固定器的应用结果。该固定器的结构允许背侧和跖侧操作,可减轻创伤后关节僵硬。它还能对软组织进行适当观察,并对失活组织进行清创以及随后的手术重建。在我们用Dynastab - S固定器治疗的27例病例中,平均治疗16周,所有病例均观察到满意的骨愈合过程。肢体功能得以维持,患侧跖屈与对侧未受影响关节相当。仅1例术后治疗出现复杂性反射性交感神经营养不良。我们的观察表明,采用现代外固定技术可实现骨折的适当愈合,且下肢功能完全恢复。