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

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.

Keywords

• malleoli fractures, volkmann's triangle, osteosynthesis