Abstract
Background Management of patients with sequelae of intra-articular fractures of the distal tibia continues to be a substantial clinical challenge in orthopaedic trauma due to the high incidence, poor outcomes and high disability rate. The objective was to review Russian and international experience in repair of intra-articular ankle fractures and explore contemporary trends in treatment strategies. Material and methods The literature search was produced using medical electronic databases of eLibrary, PubMed, Medline, SpringerLink between 2000 and 2020 and keywords: cruzarthrosis, arthrodesis, total ankle arthroplasty, arthroscopy, distal tibia, ankle joint, joint replacement, intra-articular fractures of distal tibial. Results The article presents an insight into the problem of malunited and nonunited ankle fractures, ankle contractures and deformities, post-traumatic ankle arthritis. Major surgical techniques used to address sequelae of ankle fractures include correcting osteotomy, arthroscopy, distraction arthroplasty, arthrodesis, total ankle arthroplasty with the advantages and disadvantages with each of the practices. Discussion The surgical option would depend on the time of injury, condition of soft and bone tissue, malalignment and severity of ankle arthritis. Joint saving procedures of correcting osteotomy, arthroscopy or distraction arthroplasty can be applied at early stages of the disease, and arthrodesis or total ankle arthroplasty are secured for terminal stages of ankle arthritis. Benefits of total ankle arthroplasty include preservation and improvement of ankle mobility, a short inpatient period. Ankle fusion is associated with less complication rate and low costs. Conclusion There is an obvious need for a uniform treatment algorithm with specific indications and contraindications to each surgical option.
Highlights
IntroductionManagement of patients with sequelae of intraarticular fractures of the distal tibia continues to be a substantial clinical challenge in orthopaedic trauma due to the high incidence (medial and lateral malleolar fractures, broken anterior and posterior aspects of the tibia) that ranges 71 to 187 cases per 100,000 population [1–3]
Management of patients with sequelae of intraarticular fractures of the distal tibia continues to be a substantial clinical challenge in orthopaedic trauma due to the high incidence that ranges 71 to 187 cases per 100,000 population [1–3]
The complexity of surgical treatment of the consequences of intra-articular injuries of the distal tibia is associated with concomitant alteration of the articular surfaces that make up the ankle joint, and chronic instability of the joint, developing as a result of injury to the capsular ligamentous apparatus
Summary
Management of patients with sequelae of intraarticular fractures of the distal tibia continues to be a substantial clinical challenge in orthopaedic trauma due to the high incidence (medial and lateral malleolar fractures, broken anterior and posterior aspects of the tibia) that ranges 71 to 187 cases per 100,000 population [1–3]. The complexity of surgical treatment of the consequences of intra-articular injuries of the distal tibia is associated with concomitant alteration of the articular surfaces that make up the ankle joint, and chronic instability of the joint, developing as a result of injury to the capsular ligamentous apparatus. Management of patients with sequelae of intra-articular fractures of the distal tibia continues to be a substantial clinical challenge in orthopaedic trauma due to the high incidence, poor outcomes and high disability rate. Material and methods The literature search was produced using medical electronic databases of eLibrary, PubMed, Medline, SpringerLink between 2000 and 2020 and keywords: cruzarthrosis, arthrodesis, total ankle arthroplasty, arthroscopy, distal tibia, ankle joint, joint replacement, intra-articular fractures of distal tibial
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