The looped ankle injury caused by cord strangulation / 中华骨科杂志

ABSTRACT

Objective To investigate the characteristics of looped ankle injury caused by cord strangulation, seek proper treatment to decrease amputation rate, and restore limb function as much as possible. Methods Among the nine patients with looped strangulation ankle injury, 7 had both their anterior and posterior tibia arteries involved, while the other 2 patients had only their posterior tibial artery involved. There were 4 patinets suffered from combined open tibia and fibula fractures, 2 patients from close tibia and fibula fractures; and another 2 patients from external malleolus fracture. The interval from injury to treatment varied from 6 to 27 hours(average 12 hours). All patients were treated with surgical procedures as soon as possible, blood vesseles and nerve injuries were detected and anastomosis had been done if necessary. All fractures were fixed externally. Results The limbs of all 9 patients were salvaged successfully. Most function of the injured limbs were restored. Only one external malleolus fracture malunited and was treated successfully by subsequent osteotomy. Conclusion Emergent intervention is of great importance to looped ankle injury caused by cord strangulation. Once blood vessel or nerve injuries are suspected, surgical detection or anstomosis if neccessary, should be done as soon as possible. All the associated fractures should better be fixed externally, and in order to avoid "tourniquet effect"the injured skin should be incised as early as well. With proper limb salvage procedure, good or excellent result may be achieved even in the patient with a delayed diagnosis.