ABSTRACT
Fractures of the medial and lateral malleoli are frequently associated with fractures of the posterior malleolus, comprising trimalleolar fractures. The posterior fragment may be posteromedial or posterolateral and its size determines the necessity for surgical or non-surgical treatment. The authors describe a case of trimalleolar fracture with double involvement of the posterior malleolus, both a posteromedial and posterolateral fragment. A modified transmalleolar operative approach for internal fixation is recommended when dealing with such complex trimalleolar fractures of the ankle.
Subject(s)
Ankle Injuries/surgery , Ankle Joint/surgery , Fracture Fixation, Internal/methods , Fractures, Bone/surgery , Fractures, Comminuted/surgery , Ankle Injuries/classification , Ankle Injuries/complications , Emergencies , Female , Fractures, Bone/classification , Fractures, Bone/complications , Fractures, Comminuted/complications , Humans , Internal Fixators , Middle AgedABSTRACT
Complete dislocation of the talus is an extremely rare injury. We report on a case that was treated according to a surgical technique described by Günal et al. According to this technique, a pseudarthrosis is created between the tibia and the calcaneus by transposing and fixing the medial malleolus laterally and displacing the entire foot anteriorly. The result was considered to be initially unsatisfactory. At the 2-year follow-up examination, the outcome was considered to be satisfactory. This was attributed to preservation of motion and stability in the new mortise.
Subject(s)
Fractures, Bone/surgery , Talus/injuries , Adult , Fractures, Bone/classification , Humans , Male , Osteotomy/methods , Talus/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
Between 1983 and 1994, 15 patients (range 18 to 62 years) with acute traumatic Achilles tendon rupture, were treated surgically in our Department. We employed a modified Bosworth technique. The modifications were the use of a shorter strip of tendon and more secure fixation of the proximal and distal stump, than the original Bosworth technique. Postoperatively an above - knee plaster cast was applied with the knee flexed 30°-40° and the foot in a relaxed equinus position. The plaster cast was changed to a below - knee after 4 weeks and the foot gradually dorsiflexed to a neutral position until the 8th week, and then the plaster cast was removed. No patient had wound separation, infection or skin sloughs. After an average follow-up of 9 years, no rerupture has been reported and all the patients have returned to their pre injury activities.
