Multiple fractures ankle
Traumatology / / August 12, 2017
to this type of complex fractures include fractures of the ankle and the heel bone, fractures of the ankle and metatarsal bones, fractures and fractures of the ankle or perelomovyvihi talus.
Fractures of the ankle and Talus are typical combinations of the affected leg and the tarsus.Fracture of the talus is combined with damage to either the inside or the outside of the ankle, at least - with both.Fractures of the ankle, while the talus fracture occur as a result of indirect effects of forces.
The combination of the inner ankle fracture and perelomovyviha talus occurs simultaneously: with a strong extension of the foot neck of the talus is pressed against the front edge of the tibia and broken, resulting in the body of the talus sprained posteriorly and medially, breaking and thereby displacing the inner ankle.Fractures of the lateral malleolus combined with compression fractures of the talus, appearing in the fall of the entire sole of the foot area in the position of pronation, the outer part of the
Conservative treatment of these lesions in the majority of cases end arthrodesis (60%).Some progress in the outcome of this complex trauma has been a distraction, after the application of treatments using the apparatus of external fixation of bone fragments.The dosage distraction of the ankle, as well as dosage and aimed mikrodistraktsiya fragments of the talus improve blood supply to the fracture zone, stimulate regeneration and serve as a powerful preventive measure early development of contractures and deforming arthrosis.
Causes of ankle and calcaneus fractures are most often fall to the feet of heavy objects (which is usually the direct and indirect injury to the lower leg - heel), fall from height and hit a moving vehicle, and - compression of the hindfoot in different circumstances.
Treatment of these patients is more often conservative: closed reduction and immobilization of circular plaster cast for a period of 3-4 months.When casting plaster is necessary supinate heel and well modeled longitudinal arch of the foot.
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fractures internal (usually) and the outer anklecombined with fractures or dislocations metatarsal bones are the result of direct trauma - drop weights on the lower part of the leg and foot and hit the foot and slipping it out of the transport wheels.There can be observed fractures (or dislocations) several metatarsal bones, mostly on the side of a broken ankle.As a rule, it is hard to damage, the main role in which plays multiple fractures of the metatarsal bones with displacement.Manual reduction of dislocation is not always possible, as well as recurrence after reduction.Much easier reposition distraction device of the two half rings with screw struts.Spokes conducted through bones and metatarsal diaphysis calcaneus (perpendicular and parallel to the axis of the foot sole plane).By dosed distraction of the foot and at the same time manual override easily eliminate all kinds of bone displacement, after which they are fixed to each other percutaneously 1-2 needles (for 2-3 weeks).Then remove the distraction device and put a plaster cast (with the good performance of the arches of the foot) for 1.5-2 months.Further instep prescribed for 1-1.5 years.
Combined tear fractures of the outer ankle and the base V metatarsal bones are more common in the elderly, but may also occur in athletes.The basic mechanism: tucking her foot inversion in the equinus position.Treatment consists in the application of circular plaster bandage to the knee for 3 weeks, restored ability to work in 5-6 weeks.With fractures ankle fractures combined and perelomovyvihi navicular, cuboid, and fractures of the sphenoid bone, subtalar dislocation of the foot.