[Ortho] crush distal ttibia

[Alexander Chelnokov]

Dear Marek.

You wrote 6 ноября 2008 г., 12:46:01:


MK> There,s no signs of infection but condition of skin is bad (large
MK> contusion, Tscherne 3 ) What kind of treatment: definitivly or
MK> staged ? Internal fixation (plate) or maybe nail + screws ?
MK> Ilizarov is an option...

As i realize skin condition now is crucial. Images of its appearance
are not provided. Until skin problems are solved, temporary ex-fix
is most safe and reliable solution. Monolateral fixator would be more
friendly for soft tissue procedures. When the skin problems are solved (free
flap, split grafting or whatever is suitable/available) nailing
becomes the best definitive fixation.
The fibula is broken, syndesmosis disrupted - it would be better to
repair the mortise by ex-fix. Then with nailing the proper length of
the fibula along with closed tibia/fibula gap can be maintained by a
single "position" screw.



-- 
Best regards,
Alexander N. Chelnokov
Ural Scientific Research Institute
of Traumatology and Orthopaedics
7, Bankovsky str. Ekaterinburg 620014 Russia