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Introduction: Orthopedic surgeons have long acknowledged the difficulty of treating distal tibia and fibula fractures with posterior malleoli fractures in individuals with medical comorbidities due to a lack of inadequate blood supply. Aged Type 2 diabetic individuals, with distal tibia and fibula fracture with posterior malleoli fracture, are more prone to complications such as non-union, wound infection, and delayed bone healing. It is debatable whether surgical or non-invasive treatment is preferable for diabetic complex fractures. Case Report: A 62-year-old male suffered a right distal tibia and fibula fracture with posterior malleoli fracture following an incidental fall followed by a hit over the iron rod. The patient was treated conservatively with POP for 6 weeks due to the patient's refusal of surgical management. Radiography after 6 weeks revealed features of non-union. Conclusion: The Ilizarov external fixation with bone graft was planned later to treat the non-union distal tibia and fibula fracture with posterior malleoli fracture. About 18 months after the Ilizarov fixation radiography reviewed the features of the union and clinically also patient improved.
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Objective To summarize and analyze the effect of mannitol combined with Xueshuantong on the treatment of early swelling and pain in patients with tibial and fibula fracture. Methods In Huzhou central hospital from June 2014 to January 2017, 100 cases with early swelling and pain with tibia and fibula fractur were divided into the observation group (50 cases) and the control group (50 cases). The control group were given routine mannitol combined with Xueshuantong treatment and routine nursingcare, at this basis, the observation group were received nursing intervention. The effect of the treatment and nursing in the two groups were compared. Results The total effective rate, nursing service satisfaction and the VAS score after treatment between the two groups were statistically significant (P<0.05). Conclusion The treatment of mannitol combined with Xueshuantong and strengthening clinical nursing intervention is helpful to improve the therapeutic effect and alleviate the pain of the patients with early swelling and pain with tibia and fibula fracture.
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BACKGROUND: Nonunions of the tibia represent challenging orthopedic problems, which require the surgeon to analyze numerous factors and choose an appropriate treatment. This article presents a case report of tibia and fibula fracture patient who failed the internal fixation surgery and successfully recovered after one course of percutaneous autologous platelet lysates injection. CASE DESCRIPTION: The patient received an internal nickelclad breakage at 9 months post-surgery but reluctant to accept a second surgery, then autologous platelet lysates (APL) injection which is a less invasive method was recommended. The injections were carried once a week for three times. Radiologic evaluation was conducted every month until recovery. DISCUSSION AND EVALUATION: To the best of our knowledge, this is the first reported case of tibia delayed union with breakage of the plate resolved with APL injection. Improved clinical evidence was observed at 4 and 6 months after injection. The patient got good bony union at 8 months post-injection. The patient didn't feel any discomfort postinjection, no complications such as infection, refracture etc. were observed. CONCLUSIONS: APL percutaneous injection could be a new therapeutic option for the treatment of nonunion or delayed healing fractures.
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Objective To explore the relationship among resilience, general self-efficacy and coping styles of inpatients with tibia and fibula fracture. Methods Totally 104 inpatients with tibia and fibula fracture who met the conditions were investigated with General Self-Efficacy Scale, Connor-Davidson Resilience Scale and Medical Coping Modes Questionnaire. Results The total score of resilience with tibia and fibula fracture inpatient was 52.36 ± 9.56, which had a positive relationship with general self-efficacy and self-improvement coping style. Educational level, general self-efficacy, facing coping and yielding coping styles were influencing factors of resilience in patients with tibia and fibula fracture. Conclusions The level of resilience in patients with tibia and fibula fracture needs to be improved. Health care workers should pay attention to improve patient′s general self-efficacy, focus on patient′s coping styles and strengthen psychological health education of lower degree patients.
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INTRODUCTION: Open crus fracture is still difficult in clinical treatment because of the delayed fracture union and high rate of nonunion after the operation. A consensus has been reached that mechanical stress can promote fracture healing. We independently developed a stress stimulator, which can provide longitudinal pressure for the fixed fracture end of the lower legs to promote fracture healing. The purpose of this study is to explore the advantages and clinical effect of the rap stress stimulator applied for open crus fracture after skeletal external fixation. MATERIAL AND METHODS: One hundred and sixty-five patients (183 limbs) who suffered from open tibia and fibula fracture received skeletal external fixation, of which 108 limbs were treated with the rap stress stimulator after external fixation and 75 limbs were treated with regular functional exercises of muscle contraction and joint activity only. Then the fracture healing time and rate of nonunion were compared between the two groups. RESULTS: The mean fracture healing time and rate of nonunion in the group treated with the rap stress stimulator were 138.27 ±4.45 days and 3.70% respectively, compared to 153.43 ±4.89 days and 10.67% in the group treated without the stimulator. CONCLUSIONS: The rap stress stimulator significantly shortened the fracture healing time and reduced the rate of nonunion for treating open tibia and fibula fractures.
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PURPOSE: To investigate the effect of fibular malreduction on ankle joint after tibia interlocking IM nailing of tibial and fibular fractures according to type of fibular fractures at preoperation. MATERIALS AND METHODS: Thirty-nine patients who had ipsilateral tibiofibular fracture were analyzed clinically and radiographically. The talocrural angle and the distance from joint line to the tip of fibular were measured on both ankle standing AP view. The difference of angle and distance of both ankle were analyzed by paired t-test and correlation between defference and AOFAS score by Spearman correlation coefficients. RESULTS: The difference of The talocrural angle and the distance from joint line to the tip of fibular of both ankle was statistically significant (p0.05). CONCLUSION: In tibia interlocking IM nailing of tibia and fibula fracture, malreduction of fibula could cause the change of ankle joint.
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Humanos , Articulação do Tornozelo , Tornozelo , Fíbula , Articulações , TíbiaRESUMO
Objective To study the effect of internal fixation of fibula on treatment of tibia and fibula unstable fractures. Methods 50 cases with middle and lower 1/3 fractures of tibia and fibula were treated with internal fixation of fibula and close reduction and external stabilization of tibia. Fibula was stabilized with plate and screw or intramedullary nail. Results All the 50 cases of the fracture achieved clinic union, reduction was satisfactory, and the average time of clinical union was 5 months. The functions of the joint were normal. No skin necrosis or infection occurred. Conclusion Fixation of fibula is suitable for treatment of close fracture combined with local skin injury or open fractures of tibia and fibula and lower 1/3 comminuted fracture of tibia combined with fibula fracture.
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Objective To study the results of treatment of open fracture of tibia and fibula by external fixation with unilateral multifunction external fixation apparatus(UMEFA) and plaster in different period. Methods 89 cases with open fracture of tibia and fibula had got reduction and external fixation with UMEFA and then divided into two groups, group A of 53 cases followed by external fixation with UMEFA, 8 cases of them were forced to remove UMEFA because of complications, the other 45 cases followed by external fixation with UMEFA till bone union, group B of 36 cases were removed UMEFA and changed with plaster when the skin was healed, the sweal was eliminated and the bone was steady. Compared and analyzed the results by complication, healing time and quality.Results In group B, there was less complications(P
