Surgical management of malunited fracture-dislocation of the ankle

The aim of the paper is to present the experience gained in surgical treatment of malunited fracture dislocation of the ankle. Between 1989 and 1993, five patients with malunited fracture-dislocation of the ankle [one pylon fracture] were treated surgically. All five cases were males with age range 20-50 years. They were received 6-12 weeks after injury. During the period of delav three cases had primary inefficient treatment and two did not have any treatment. The patients' complaint was deformity and loss of function. Surgery was in the form of corrective osteotomy of the malleoli, reduction of the fragments, and restoration of alignment. Internal fixation was carried out using AO refined rules and was dictated by the fracture profile. were evaluated according to the Weber Scoring System as modified by Marti etal and was found to be excellent in one, good in two and fair in two cases

Internal fixation with and without tourniquet

Comparison of the reaction of the limb to the use or non-use of the tourniquet during the operation of internal fixation of fractures of the bones of the leg or the forearm. 52 cases of closed fractures of leg and forearm bones. This study is prospective double blind where the patients were divided in two groups of 26 cases each. In the first group internal fixation of the fracture was done under tourniquet, while in the second group the tourniquet was not used. The patients were examined for the incidence of postoperative complications for three weeks. The group where surgery was done without tourniquet showed less complication rate, such as redness, swelling, superficial infection and skin blebs. Also the swelling in the tourniquet group did not subside throughout the observation period. The tourniquet, although being useful, should not be used in operating on fractures of the leg and forearm bones by internal fixation whenever possible