Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL.
Departments of Surgery & Pediatric Surgery, McGill University Health Center, Montreal, QC, Canada.
J Orthop Trauma. 2018 Aug;32 Suppl 1:S38-S39. doi: 10.1097/BOT.0000000000001205.
Severe injuries to the ankle frequently result in soft tissue trauma too severe to proceed with immediate definitive fixation. Additionally, patients with multiple or vascular injuries may need a temporizing measure before undergoing definitive treatment. Temporizing, ankle-spanning external fixation offers a management strategy that allows for soft tissue rest and prioritized treatment of patients with polytrauma.
The video demonstrates 2 clinical cases managed with temporizing, ankle-spanning external fixation: a pilon fracture and a bimalleolar ankle fracture-dislocation.
The indications, advantages, and a systematic operative approach to applying ankle-spanning external fixation are presented. Specific attention is paid to restoring an anatomic alignment of the ankle.
Temporizing, ankle-spanning external fixation is an important modality in the management of fractures about the ankle, especially in patients with dislocation and/or severe soft tissue injury. A systematic approach that initially addresses length, followed by sagittal and coronal plane correction, can be used to restore anatomic alignment of the ankle.
踝关节严重损伤常伴有严重的软组织创伤，无法立即进行确定性固定。此外，多发性或血管损伤的患者在接受确定性治疗前可能需要采取临时措施。临时性跨踝外固定架提供了一种管理策略，可使软组织得到休息，并优先治疗多发创伤患者。
该视频演示了 2 例采用临时性跨踝外固定架治疗的临床病例：一例 Pilon 骨折和一例双踝骨折脱位。
介绍了跨踝外固定架的适应证、优点和系统手术方法。特别注意恢复踝关节的解剖对线。
临时性跨踝外固定架是踝关节周围骨折治疗的重要手段，尤其适用于伴有脱位和/或严重软组织损伤的患者。一种系统的方法，首先解决长度问题，然后再解决矢状面和冠状面的纠正，可以用于恢复踝关节的解剖对线。
