However, there was mild sensory blunting over the dorsum of the foot. The sensation on the sole of the foot was normal. The dorsalis pedis pulse was not palpable and it was only feebly heard with a handheld Doppler. The leg sagged even when supported distally, but, surprisingly, active toe movements were present and the posterior tibial pulse was palpable. There was minimal contamination of the wounds. He was in a state of shock and the skin of the entire left leg had multiple sieve-like punctured wounds through which small spikes of bones were visible. Case reportĪ 32-year-old man, a manual labourer in a granite quarry, presented after heavy equipment had fallen on his left leg while working. To our knowledge, no similar case of successful salvage of a completely shattered tibia has been reported. Limb salvage finally resulted in a fully functional limb after five surgical procedures during three years. This is a report of a patient with a completely shattered type III A fracture of the left tibia sustained at work. Surgeons are faced with the dilemma of deciding whether to amputate or save the extremity. Treatment is protracted with a high incidence of secondary amputation in types III B and III C fractures. 1 These are prone to severe complications such as infection and nonunion. The sparse anterior soft-tissue cover results in many of these injuries being grouped under type III of the Gustilo-Anderson classification. Pregabalin versus sertraline in generalized anxiety disorder.Open fractures of the tibia are common.National prevalence and socioeconomic factors associated with the acceptance of COVID-19 vaccines in South Korea: a large-scale representative study in 2021.Tumor microenvironment: recent advances in various cancer treatments.Importantly, at their last follow-up visit, the fracture was in excellent position and healed radiographically, and the patient could walk without pain and support.ĬONCLUSIONS: One-incision double-plating is a safe and effective alternative for treatment of distal tibia and fibula fractures. There were no cases of malunion or non-union. Only one patient with delayed union healed without surgical intervention by 7 months postoperatively. RESULTS: Postoperative follow-up showed that 24 fractures healed within the range of the normal healing time. All patients were followed-up at least until the patient was fully weight-bearing and the soft tissues had healed (median, 15 months range, 12-24). The type of fractures based on AO classification were A1 (n = 6), A2 (n = 4), B1 (n = 12) and C1 (n = 3). The reduction and fixation of the tibia and fibula were conducted in all patients using one incision. PATIENTS AND METHODS: Twenty-five patients with fractures of the distal third of the tibia-fibula, were treated with one incision, double plating between June 2007 and January 2009. To decrease and prevent aforementioned serious complications, one-incision double-plating technique was advocated here.ĪIM: The aim of this work was to evaluate the results and effects of the one-incision, double-plating technique in the fractures of distal third of the tibia-fibula and fibula. OrthopedicsīACKGROUND: The treatment of fractures of the distal third of the tibia and fibula usually involves two incisions, thus raising the risk of wound dehiscence, wound necrosis, infection, and the delayed union or non-union of distal tibial fractures. Double plating for the treatment of distal tibia and fibula fractures: case series of twenty five patientsĭepartment of Orthopaedics Surgery, Shanghai First Rehabilitation Hospital, Shanghai, China.
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