Ankle fractures and rapidly progressing osteoarthrosis of the ankle joint: prevention and treatment

Omelchenko, Taras

doi:10.15674/0030-59872013435-40

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Високий відсоток незадовільних результатів лікування пацієнтів із травмами в зоні надп'ятковогомілкового суглоба, що досягає 37 %, обумовлює необхідність подальшого реконструктивно-відновного лікування в майже 18 % постраждалих [1,3,4]. Адекватний вибір виду та методики реконструктивного хірургічного втручання є складним і багатокомпонентним процесом, під час якого слід ураховувати як клінічну ситуацію на момент звернення пацієнта, так і прогноз ефективності лікування.…”

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Correlation of elastic modulus and x-ray bone density in the area of the ankle joint

Omelchenko¹,

Burianov²,

Lyabakh³

et al. 2018

ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS

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Цель: эмпирическим путем (в натурном экспериментальном исследовании) определить взаимосвязь между рентгенологической плотностью и модулем упругости костной ткани в области голеностопного сустава. Методы: определен модуль упругости 10 образцов корковой костной ткани большеберцовой кости и 42-спонгиозной костной ткани дистального отдела большеберцевой (ББК), малоберцевой (МБК), таранной костей. Исследование модуля упругости костной ткани проводили путем регистрации линейных перемещений при статических и квазистатических комп рессионных нагрузках. Рентгенологическую плотность в единицах Хаунсфилда (HU) оценивали с помощью компьютерной томографии (КТ). Результаты: установлено,

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Section: вступunclassified

Correlation of elastic modulus and x-ray bone density in the area of the ankle joint

Omelchenko¹,

Burianov²,

Lyabakh³

et al. 2018

ORTHOPAEDICS, TRAUMATOLOGY and PROSTHETICS

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“…Despite a great variety of surgical and conservative methods of treatment of such lesions, the number of unsatisfied results amounts to 7-38% [3][4][5], and in heavy pronation fractures to 20-40% [6]. Traumas in this region occur in 60-70% of the working age population.…”

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confidence: 99%

“…Invalidization in such pathology is 8. .0% [3][4][5]. The main causes of arthrosis are: unrepaired subluxation of the foot or chronic dislocation fracture of the ankle joint, unsatisfactory reposition of the fragments after ankle fractures, chronic instability caused by the injury of the ankle joint ligamentous apparatus [9][10][11][12].…”

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The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

Gorbatov¹,

Горін²,

Павлов³

2016

Sovrem Tehnol Med

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The aim of the investigation was to work out a concept of modern arthrodesis of the ankle joint in posttraumatic crusarthrosis, grade III-IV, using innovative fixing implants.Materials and Methods. The results of treating 53 patients covering the period from 1 to 15 years after 56 operations of arthrodesis, performed for posttraumatic crusarthrosis, grade III-IV (according to Kellgren and Lawrence classification), have been analyzes. The conclusions were based on the data of radiographic, clinical examination and the scoring according to the international rating scale AOFAS. Arthrodesis was performed using state-of-the-art fixing implants: with the help of the screws, retrograde intramedullary HAN rod, Ilizarov apparatus for external fixation, wires.Results. In the majority of patients (41%) the main cause of developing posttraumatic crusarthrosis of grade III-IV was unrepaired intraarticular dislocation of the ankle fragments and a large fragment (more than 1/3) of the posterior tibia margin. The best results, i.e. fewer ligamentous ankylosis (32%) and the greatest number of good (39%) and satisfied (54%) results according to AOFAS scale were obtained when crossed screws were used in arthrodesis. It was estimated, that the assessment of clinical and functional signs according to the international scale AOFAS does not reflects the most vital spectrum of life activity indices of patients, therefore, it has been suggested to use additionally individualized indices characterizing the quality of life of patients of various professions, levels of every-day activity and psychological motivation to adequate rehabilitation. Unsatisfied radiographic findings did not always corresponded to the poor clinical results. In 56% of patients with ligamentous ankylosis the result according to AOFAS was good or satisfactory (slight pains in prolonged walking, moving without additional supporting means, absence of evident limping).Conclusion. The worked out concept of modern arthrodesis is as follows: 1) the choice of ankle arthrodesis method and the type of a fixing implant must depend not only on the type of deformation, but on the patient's age, gender traits, diseases contributing to the development of unfavorable treatment results; 2) the best clinical and functional results are connected with the method of fixation providing primary stability, and with regenerative and adaptive capabilities of patients in diverse age groups; 3) the most optimal state-of-the-art implants for arthrodesis are crossed screws for fixation, providing the greatest strength and good primary compression, if there is no marked disorder of blood supply of the articular bones and radical removal of the cartilaginous tissue.

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Revision surgeries following ankle arthrodesis fixed with retrograde intramedullary nails affected by mechanical complications

Grazhdanov,

Zuev,

Kauts

et al. 2023

N.N. Priorov Journal of Traumatology and Orthopedics

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BACKGROUND: 25 percent of all musculoskeletal diseases that involve joints of the lower extremities accrues to ankle arthrosis. Late stages of this disease are indications for ankle arthrodesis. To date, surgeons who perform ankle arthrodesis do not agree about both the treatment technique for ankle articular surfaces and the method of their fixation, but other studies and our own observations suggest that 8 to 20 percent of the surgeries performed with retrograde locking rods lead to revision interventions due to the disorder of ankle ankylosis formation caused by mechanical complications associated with the implanted fixators (aseptic loosening of their parts, stress fracture of the intramedullary nail or locking screws, peri-implant tibia fracture). CLINICAL CASES DESCRIPTION: The aim of this work was to study and demonstrate the results of revision surgical interventions performed for failed ankylosis after ankle arthrodesis with intramedullary rod fixation against the development of mechanical complications. Clinical observations of revision interventions for failed ankylosis of the ankle joint against the complications due to mechanical origin using a retrograde blockable intramedullary rod as the primary fixator were carried out. Our work presents the technology of revision surgical interventions in case of compromised processes of ankle joint bone block formation associated with aseptic loosening of the structural elements, stress fracture of the intramedullary rod and blocking screws, tibial peri-implant fracture. CONCLUSION: Revision surgery for complications due to mechanical origin after ankle arthrodesis with intramedullary rod fixation requires an individual approach in each clinical case.

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Ankle fractures and rapidly progressing osteoarthrosis of the ankle joint: prevention and treatment

Cited by 4 publications

References 7 publications

Correlation of elastic modulus and x-ray bone density in the area of the ankle joint

Correlation of elastic modulus and x-ray bone density in the area of the ankle joint

The Concept of Modern Ankle Joint Arthrodesis in Posttraumatic Crusarthrosis, Grade III–IV

Revision surgeries following ankle arthrodesis fixed with retrograde intramedullary nails affected by mechanical complications

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