[Arthroscopic treatment of avulsion fracture of tibial origin with Ⅰ degree supination and external rotation injury]
Zhonghua wai ke za zhi [Chinese journal of surgery] | 14 Mar 2019
SM Feng, SC Zhang, AG Wang and ZY Zhang
Objective: To analyze the clinical effects of all-inside arthroscopic treatment for the patients of avulsion fracture of tibial origin withⅠdegree supination and external rotation injury according to the Lauge-Hansen classification. Methods: A retrospective analysis of 34 patients (34 feet) who had underwent all-inside arthroscopic for avulsion fracture of tibial origin with Ⅰ degree supination and external rotation injury from September 2015 to September 2017 in Department of Hand and Foot Microsurgery, Xuzhou Central Hospital. There were 20 males and 14 females, aged (24.7±11.3)years (range:14-43 years). The duration from injury to operation was (4.3±2.5) d (range: 6 h-7 d). The pro-operation visual analogue scale(VAS) of pain was 6.8±1.4(range: 4-8). All the patients were treated with the all-inside arthroscopic procedure by using the anterolateral and near-anterolateral portals and the fractures were fixed with cannulated screws. Main outcome measures included the pain, foot appearance, and patients were scored using the American Orthopaedic Foot & Ankle Society Lesser Toe Metatarsophalangeal-Interphalangeal Scale(AOFAS). Results: Primarily healing of the wound was achieved in all cases without postoperative complications of nerve, vessel and tendon injury. The follow-up period was (16.9±6.6)months(range: 8-24 months). Postoperatively X-ray films showed complete fracture healing at (11.2±2.1)weeks after surgery.At the last follow-up, the ankle movement and appearance were good, and no ankle joint traumatic arthritis were found. The VAS and AOFAS was 0 and 95.7±9.4 respectively. Conclusion: The all-inside arthroscopic treatment of Lauge-Hansen type avulsion fracture of tibial origin with Ⅰ degree supination and external rotation injury is an effective and precise method, with accurately outcomes, precise reduction and minimally postoperative complications.
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