"""Logsplitter"" injury in clinical treatment and prognosis evaluation in ankle fractures" / 中华骨科杂志

ABSTRACT

aration caused by varieties of violence does not catch the attention of domestic orthopedic surgeons enough in the past years.This passage is to discuss the damage mechanism,clinical treatment and prognosis evaluation of this kind of injury through the analysis of the case of Logsplitter injury.Methods Retrospective analysis 23 patients of Logsplitter injury from December 2006 to December 2014,male in 17 cases,female in 6 cases,average age (43.68±12.67) years (21-60 years).Hurt injury in 9 cases,sports injury in 1 case,falling injury in 2 cases,traffic injuries in 10 cases,crushing injury in 1 case.Open injures in 10 cases,of which the Gustilo Ⅱ type in 7 cases,Gustilo Ⅲ A type or above in 3 cases,closed injuries in 13 cases.According to the AO/OTA fracture classification,44c type in 19 cases,44b type in 3 cases,44a type in 1 case.Fibula fractures in 22 cases,19 cases of medial malleolus fracture.Results 23 patients received follow-up,with an average period was (0.91±0.26) years (0.4-2.37 years).21 cases underwent open reduction internal fixation (ORIF),2 cases underwent closed reduction external fixation and K-wire fixation.17 cases were fixed with the syndesmosis screws,among them,1 screw was used to fix 14 cases,two screws were used to fix 3 cases;the utilization rate of 3.5 mm screws is higher,at 94.1％,and all screws were entered through 3 layers of cortical;Combined with medial malleolus fracture cases were fixed with cannulated screws/K-wire internal fixation.Average healing time of the skin surrounding the ankle skin was (2.26±1.91) weeks;average healing time of fracture was (15.34±5.13) weeks;Joint pain ocurred combined with joint space narrowing after loading in 18 cases,at 78.3％;Postoperative infection,2 cases,the proportion was 8.7％;Fracture delayed union 1 case.Functional examination of the ankle joint (angle measurement method)Dorsiflexion average angle (23.9±2.21)degrees,Plantar flexion average angle (32.1 ±4.13) degrees.Average angle of introversion was (23.91 ±2.24) degrees.Hallux valgus average angle (27.6±3.81) degrees.75 points and over were got in AOFAS in 21 cases,the ratio of excellent was 91.3％.Conclusion Logsplitter injury represents a kind of important and unique ankle fracture,dislocation and the inferior tibiofibular syndesmosis separation caused by varieties of violence,accompany with potentially soft tissue injury and platford injury,according to existing treatment principle and treatment strategy summarizied by us,the clinical therapeutic effect of this damage is ideal,functional recovery is relatively satisfactory prognosis.