Treatment of B3 type fractures of shin bones associated with Volkmanns triangle fracture

  • A.Ju. Fil The Danylo Halytsky National Medical University in Lviv
  • Ju.Ja. Fil The Danylo Halytsky National Medical University in Lviv
  • I.R. Trutjak The Danylo Halytsky National Medical University in Lviv
  • Ju.I. Senjuk The Danylo Halytsky National Medical University in Lviv
  • N.V. Levytsky The Danylo Halytsky National Medical University in Lviv
  • M. Valigursky The Danylo Halytsky National Medical University in Lviv
Keywords: malleoli fractures, Volkmann's triangle, osteosynthesis

Abstract

Aim. Fractures of shin bones are the most common injuries of bones of the lower extremity. Most fractures involve ligament lesions. There are several methods for reduction of the bones, though the aim of treatment still is the stable anatomical reduction and position of the lateral bone in the ankle mortise joint and correction of fibular length. The need for surgical treatment of fractures of the lateral and medial malleoli is obvious to date, although the issue of fracture reduction of the posterior edge remains open. Objective to optimize the treatment of B3 type fractures triangle and Volkmann's fracture as a component of fractures of shin bones.

Material and Methods. During the period from 2013 to 2016 43 patients with B type fractures of shin bones and B3 type fractures of the posterior edge of the tibia were treated at the department of traumatology and orthopedics of Lviv City Municipal Clinical Hospital No8, which were divided into 2 groups. In the study we used the classification of fractures by Danis-Weber (as modified by AO/ASIF). In both groups the postoperative treatment included early exercising active movements in the ankle joint from the first day after surgery.

Results and Discussion. Our retrospective study produced the following results: time to achieve the full motion range in the ankle joint in the second group was shorter by 9 days, compared with the first one. Volume of movements was assessed by Olenrud & Wolander scale [9] of functional results.

Conclusions. Direct reduction and fixation of Volkmann's triangle provides anatomical arrangements of fragments and restoration of stability of the posterior intermalleolar ligament as a component of syndesmotic lesion. Anatomical reduction, stable fixation of the posterior edge and application of posterior antiglide plate for LM osteosynthesis are characterized by better stability in rotary and sliding weight bearing and enabled faster rehabilitation and axial weight bearing in the control group.

References

Lash, N., Horne, G., Fielden, J. and Devane, P. (2002) Ankle Fractures: Functional and Lifestyle Outcomes at 2 Years.ANZ Journal of Surgery, 72, 724-730. https://doi.org/10.1046/j.1445-2197.2002.02530.x

Court-Brown, C.M. and Caesar, B. (2006) Epidemiology of Adult Fractures: A Review. Injury, 37, 691-697. https://doi.org/10.1016/j.injury.2006.04.130

Court-Brown, C.M., McBirnie, J. and Wilson, G. (1998) Adult Ankle Fractures-An Increasing Problem? Acta OrthopaedicaScandinavica, 69, 43-47. https://doi.org/10.3109/17453679809002355

Daly, P.J., Fitzgerald Jr., R.H., Melton, L.J, and Ilstrup, D.M. (1987) Epidemiology of Ankle Fractures in Rochester, Minnesota. Acta Orthopaedica Scandinavica, 58, 539-544. http://dx.doi.org/10.3109/17453678709146395

Jensen, S.L., Andresen, B.K., Mencke, S. and Nielsen, P.T. (1998) Epidemiology of Ankle Fractures: A ProspectivePopulation-Based Study of 212 Cases in Aalborg, Denmark. Acta Orthopaedica Scandinavica, 69, 48-50. https://doi.org/10.3109/17453679809002356

Rohit Singh, Tame Kamal, Nick Roulohaminet all. (2014) Ankle Fractures: A Literature Review of Current Treatment Methods.Open Journal of Orthopedics, 2014, 4, 292-303. https://doi.org/10.4236/ojo.2014.411046

Bruna Buscharino, Rafael Gioso Moretti, Jose Octavio SoaresHungria et all. Biomechanical Study: Resistance Comparison of Posterior Antiglide Plate and Lateral Plate on Synthetic Models Simulating Danis-Weber B Malleolar Fractures. RevistaBrasileira de Ortopedia, 2013; 48 (3): 221-227. https://doi.org/10.1016/j.rbo.2012.09.005

Noe Martinez Velez, Arturo Saldivar Moreno, Octavio Sierra Martinez et all. Posterior antiglide plate vs lateral plate to treat Weber B ankle fractures. ActaOrtopedica Mexicana, 2004; 18(Suppl. 1): 39-44.

Olerud C, Molander H. A scoring scale for symptom evaluation after ankle fracture. Arch Orthop Trauma Surg. 1984;103:190-194. https://doi.org/10.1007/BF00435553

Published
2018-02-22
How to Cite
Fil , A., Fil, J., Trutjak, I., Senjuk, J., Levytsky, N., & Valigursky, M. (2018). Treatment of B3 type fractures of shin bones associated with Volkmanns triangle fracture. Acta Medica Leopoliensia, 24(1), 55-59. https://doi.org/10.25040/aml2018.01.055