12/15/2023 0 Comments Simple spiral fractureThe patient was in supine position and satisfied with general anesthesia or epidural anesthesia, used a tourniquet in the lower limbs. Closed the wound layer by layer after repeated flushing. After confirmed that the fracture reduction was satisfactory, the distal and proximal screws were placed in turn. After satisfactory fracture reduction, selected appropriate intramedullary nail for placement re fluoroscopy confirmed the reduction of the fracture. The guide needle should be placed at the metaphysis of the distal tibia. Then, drew and reduced the fracture, place the guide pin, and judged the fracture reduction and the position of the guide pin through fluoroscopy. The ideal needle entry point was located at 9 mm outside the midpoint of the tibial platform in the anteroposterior perspective, and the lateral perspective was located at the front edge of the anterior joint slope. The C-arm fluoroscopy machine determined the appropriate needle entry point. Usually, the infrapatellar approach was selected to place intramedullary nails to fix tibial fractures. In this study, we will introduce a technique for fixation of posterior malleolus fracture in tibial spiral fracture, which has the advantages of simple operation and small soft tissue damage, and the patients have obtained good clinical results.Īfter the patient was satisfied with the anesthesia, used a tourniquet in the lower limbs. No matter which fixation method is selected, the internal fixation device for fixing the posterior malleolus should not interfere with the distal insertion of the intramedullary nail, and the trauma to the soft tissue should be minimized when cooperating with the treatment of tibial intramedullary nail. Since most of the posterior malleolar fractures are not displaced, percutaneous screw fixation may be a better choice. At present, there is no consensus on what kind of fixation should be used for posterior malleolar fracture in this kind of injury. The fixation of posterior malleolar fracture includes open reduction plate and screw fixation or percutaneous screw fixation. showed that PMF should be fixed before intramedullary nail is placed for the injury of tibia combined with posterior malleolus fracture. There is also a risk of displacement of the posterior malleolus fracture mass during rehabilitation exercise and early weight bearing, which may require secondary surgery. In patients with posterior malleolus fractures, secondary displacement of the posterior malleolus fracture may occur during the insertion of intramedullary nailing. However, posterior malleolus fractures are joint-site fractures, and single intramedullary nailing is not appropriate for fractures involving the periarticular and metaphyseal regions. The patients have good tolerance, early bearing time, low reoperation rate and poor line of force. Intramedullary nailing is the first choice for tibial fracture fixation. As mentioned above, as clinicians realize the strong correlation between tibial spiral fracture and posterior malleolus fracture and the popularization of CT and other examination technologies, more and more posterior malleolus fractures related to tibial spiral fracture are detected, and at the same time, its treatment problems are gradually paid attention to. examined 288 patients with tibial spiral fractures and found that 16.7% had posterior malleolus fractures. Bostman first reported that 0.6% of tibial shaft fractures were complicated by ankle fractures Van der Werken and Zeegers reported an incidence of 11.5%. Tibial spiral fracture combined with posterior malleolar fracture is a regular combination, and posterior malleolar fracture(PMF)is usually hidden. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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