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首页> 美国卫生研究院文献>Diabetic Foot Ankle >Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture
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Combined circular external fixation and open reduction internal fixation with pro-syndesmotic screws for repair of a diabetic ankle fracture

机译：圆形外固定架和切开复位内固定架与前钉联合螺钉修复糖尿病性踝关节骨折

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The surgical management of ankle fractures among the diabetic population is associated with higher complication rates compared to the general population. Efforts toward development of better methods in prevention and treatment are continuously evolving for these injuries. The presence of peripheral neuropathy and the possible development of Charcot neuroarthropathy in this high risk patient population have stimulated much surgical interest to create more stable osseous constructs when open reduction of an ankle fracture/dislocation is required. The utilization of multiple syndesmotic screws (pro-syndesmotic screws) to further stabilize the ankle mortise has been reported by many foot and ankle surgeons. In addition, transarticular Steinmann pins have been described as an adjunct to traditional open reduction with internal fixation (ORIF) of the ankle to better stabilize the talus, thus minimizing risk of further displacement, malunion, and Charcot neuroarthropathy. The authors present a unique technique of ORIF with pro-syndesmotic screws and the application of a multi-plane circular external fixator for management of a neglected diabetic ankle fracture that prevented further deformity while allowing a weight-bearing status. This techniqu may be utilized for the management of complex diabetic ankle fractures that are prone to future complications and possible limb loss.
机译：与普通人群相比，糖尿病人群中踝部骨折的外科治疗与较高的并发症发生率相关。对于这些伤害，不断努力开发更好的预防和治疗方法。当需要开放复位踝关节骨折/脱位时，这种高风险患者人群中周围神经病变的存在和夏科特神经关节炎的可能发展激发了许多手术兴趣，以建立更稳定的骨结构。许多脚和脚踝外科医生已经报道了使用多个下颌骨螺钉（前下颌骨螺钉）来进一步稳定踝关节。此外，经穿刺的Steinmann钉已被描述为传统的踝关节内固定术（ORIF）的开放复位术的辅助工具，可以更好地稳定距骨，从而最大程度地减少了进一步移位，畸形畸形和Charcot神经性关节炎的风险。作者介绍了带前突肌螺钉的ORIF的独特技术，以及多平面圆形外固定器在治疗被忽视的糖尿病性踝关节骨折中的应用，该骨折预防了进一步的畸形，同时保持了负重状态。该技术可用于处理复杂的糖尿病性踝关节骨折，这些骨折容易导致将来的并发症和可能的肢体丢失。

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