Author/Editor     Silvester, Tomaž; Pšenica, Jani; Lah, Tone; Brodnik, Branko
Title     Zlomi gležnja: pozni rezultati operativnega zdravljenja
Translated title     Ankle fractures: late results of operative treated ankle fractures
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 68, št. 2
Publication year     1999
Volume     str. 71-7
Language     slo
Abstract     There is no generally accepted doctrine of operative treatment of displaced malleolar fractures. Accurate reduction is fundamental, but ways of fixation are different. Our method of operative treatment, especially minimal osteosynthesis, and postoperative proceedings were analyzed. Patients, methods, results. Between 1.1.1989 and 1.4.1994 there were 331 displaced molleolar fractures operatively treated in Jesenice General Hospital. All fractures were classified according to AO criteria. In the majority of fractures minimal osteosynthesis was performed. Early ankle exercises without weight bearing were allowed after operation. 242 of patients were followed up two to seven years after operation. The late results were from functional, clinical and radiological point of view in 87% classified as exellent or good. Conclusions. Early operation with as few osteosynthetic material as possible is our basic approach in treatment of displaced malleolar fractures. In majority of fractures minimal osteosynthesis can be performed. Stabilization of fibula with plate is necessary in some comminuted fractures of type B and in type C fractures according to AO.
Summary     Izhodišča. Kljub pogostosti zlomov gležnja ni enotne doktrine zdravljenja. Za uspešno zdravljenje zlomov gležnja je odločilna natančna repozicija, načini fiksacije pa so različni. Z raziskavo smo želeli ugotoviti uspešnost in primernost naših metod operativne oskrbe zlomov gležnja, predvsem minimalne osteosinteze, in pooperativnih postopkov. Pacienti, metode, rezultati. V petih letih, od 1.1.1989 do 1.4.1994 smo v Splošni bolnišnici Jesenice operativno oskrbeli 331 zlomov gležnja. Zlome smo razvrstili po AO kriterijih. Dislocirane zlome gležnja smo zdravili operativno. Večino zlomov (90%) smo oskrbeli po načelih minimalne osteosinteze. Pooperativno smo dovolili takojšnje razgivanje brez obremenjevanja spodnjega uda. Na kontrolo dve do 7 let po operaciji je prišlo 242 operiranih. S funkcionalnega, kliničnega in radiološkega vidika smo v 87% ugotovili odličen ali dober rezultat. Zaključki. Dislocirane zlome gležnja skušamo operirati čimprej in s čim manj osteosintetskega materiala. Večino zlomov tako oskrbimo z minimalno osteosintezo, stabilizacija fibule s splošno pa je potrebno pri nekaterih kominutivnih zlomih tipa B in pri večini zlomov tipa C po AO razvrstitvi. Rezultati pozne kontrole potrjujejo primernost naše metode pri zdravljenju zlomov gležnja.
Descriptors     ANKLE INJURIES
FRACTURES
FRACTURE FIXATION, INTERNAL
TREATMENT OUTCOME