Methods of Diagnosis and Treatment of Ankle Fractures - The Opinion of Members and Supporters of the Polish Foot and Ankle Society

Abstract

STRESZCZEnIEWstęp. Pra cę opar to na wy ni kach ba da nia an kie to we go prze pro wa dzo ne go wśród uczest ni ków III Kon gresu Pol skie go To wa rzy stwa Sto py i Sta wu Sko ko wo -Go le nio we go (Po lish Fo ot and An kle So cie ty -PF&AS), któ ry od był się w Ja star ni w dniach 22-24 kwiet nia 2010 ro ku.Ma te riał i me to dy. Wy ko rzy sta no opis kli nicz ny i ob raz ra dio lo gicz ny hi po te tycz ne go pa cjen ta, z ty po wym zła ma niem ko stek go le ni, aby okre ślić spo so by dia gno sty ki i le cze nia tych ura zów sto so wa ne w Pol sce. Uczestni ka mi ba da nia by li le ka rze or to pe dzi. Roz pro wa dzo no 85 an kiet, na któ re uzy ska no 54 od po wie dzi (63%).Wy ni ki i Wnio ski. Więk szość an kie to wa nych: roz po zna ła wła ści wy me cha nizm zła ma nia, roz po zna ła typ zła ma nia, pre fe ro wa ła le cze nie ope ra cyj ne, ale nie po tra fi ła za sto so wać kla sy fi ka cji AO. Od po wie dzi na te mat kon tro li ra dio lo gicz nej po ope ra cji nie uwzględ nia ły dłu gie go cza su ob ser wa cji, a pro po no wa ne me to dy ob razo wa nia uszko dzeń wię zo zro stu pisz cze lo wo -strzał ko we go na le ży uznać za nie wy star cza ją ce. Po da ny w od powie dziach czas i sto pień ob cią ża nia koń czy ny po ope ra cji mie ścił się w stan dar dzie po stę po wa nia. Pro po zy cje pro fi lak ty ki prze ciw za krze po wej rów nież od po wia da ły przy ję tym stan dar dom Słowa kluczowe: złamania kostek goleni, więzozrost piszczelowo-strzałkowy, leczenie operacyjne SUMMARYBackground. The present paper is based on a survey distributed among the participants of the 3rd Congress of the Polish Foot and Ankle Society in Jastarnia on April 22-24, 2010.Material and methods. A clinical description and imaging data of a hypothetical patient with a typical ankle fracture were used to identify current methods of diagnosis and treatment of such injuries in Poland. The participants were orthopaedists. Eighty-five questionnaires were distributed and 54 (63%) were completed and returned.Results and Conclusions. Most respondents correctly recognized the fracture mechanism and identified the type of fracture. They preferred operative treatment, but were not able to apply the AO classification. The answers regarding post-operative radiological follow-up did not provide for long-term follow-up and the suggested methods of imaging to detect disruption of the tibiofibular syndesmosis were insufficient. The recommendations concerning the timing and staging of post-operative weight bearing as well as antithrombotic prophylaxis complied with current standards.

Is there any change in surgeon’s attitude to the management of ankle fractures accompanying syndesmotic injury? A nationwide survey

“…[ 11 , 16 ] There is a rising demand for stress radiographs and less use of conventional radiographs in the current study (Table IV). [ 8 - 12 , 16 ] Although the decision of syndesmotic stability can be safely established with advanced radiological imaging studies such as ultrasound, computed tomography, and magnetic resonance imaging,[ 19 , 20 ] very few of the respondents reported using them.…”

“…The combined use of the hook test and other intraoperative methods was similar to the findings of previous studies. [ 8 - 12 , 16 ] However, these results showed that Turkish orthopedic surgeons do not rely on the hook test alone as much as surgeons in the Netherlands. [ 9 ] Another interesting finding from the current survey was that 15.6% of the participants stated that they had already decided before surgery whether or not they would perform syndesmotic fixation.…”