The corrective osteotomy of the shin lateral small bone in its falsely consolidated fractures
Objective. To analyze the results of application of modified procedure in the correction osteotomy of the shin lateral small bone in a falsely consolidated its fractures without significant destructive-dystrophic changes in tramatized ankle joint.
Materials and methods. The investigation was conducted in 37 patients, 16 - men and 21 - women, with average age (38 ± 7) yrs. From the trauma moment 6-15 mo passed, (7.8 ± 1.9) mo at average. During roentgenological examination in patients with posttraumatic osteoarthrosis of ankle joint the Stages I-II in accordance to Kellgren and Lawrence were established.
Correctional osteotomy have included a transverse osteotomy of lateral small bone of the shin on the level of the joint fissure, what made possible to perform a three-dimensional correction of the bone localization and to restore the interrelationship in ankle joint.
Functional results were estimated in accordance to the AOFAS (American Orthopaedic Foot and Ankle Society Score) scale for ankle joint and posterior part of foot before and after surgical treatment. The progression degree of osteoarthrosis were determined in accordance to result of roentgenography with loading in accordance to classification of Kellgren-Lawrence. Average term of observation with the results analysis have constituted (1.9 ± 0.6) yrs.
Results. Estimation of functional results in accordance to the AOFAS scale in borders of the follow-up term have increased from (58.7 ± 2.4) to (86.2 ± 1.8) points. During roentgenological examination in all the patients a restoration of the ankle joint axis was observed, but in 8 (21%) patients the osteoporosis Stage III was revealed, what have witnessed its progress.
Conclusion. Modified procedure of the correction osteotomy of the shin lateral small bone in a its falsely consolidated fractures gives possibility to restore a congruence and biomechanical axis of the joint injured, to improve significantly its functional capacity and to slow down a progress of posttraumatic osteoarthrosis.
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