Date: Fri, 7 Feb 2003 14:59:56 +0200

Subject: Distal Tibia Fibula Injury

Dear colleagues!

In our clinic we treat patient from USA (citizen of USA). This consultation is carried at the patient's request. Could be You so kind to advise!

Diagnosis: closed fractures of the both shin bones. The patient received trauma when he fell down on the street. Then he was operated and the external fixation using Ilizarov's method was carried out. All the parameters of blood and urine are normal. There are no vessel and neurological disorders.

Questions are as follows:

Thank You!

Best wishes,

dr. Anton Vladzymyrskyy
R&D Institute of Traumatology and Orthopedy
Donetsk, Ukraine

Reply at: Orthopaedic Trauma Association forum

Date: Sat, 8 Feb 2003 14:33:24 +0500

From: Alexander Chelnokov

Hello Anton,

>>4) Could you evaluate the quality of treatment?

Reduction looks quite acceptable. The foot extension appears to be unnecessary with 3-4 olive wires in the distal fragment unless a ligament injury is present but not reported.

>>5) What other methods can be used in this case?

Any :-)

But the choice IMHO was optimal.

>>6) Is it expedient to go on using Ilizarov's method, or is it worth to choose

Periarticular fractures are good indications to use the Ilizarov type fixator for definitive stabilization.

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

Date: Sun, 9 Feb 2003 16:57:57 -0600

From: Obremskey, William T

The alignment looks good and it should heal well. Be careful of equinus contracture. I would chose a percutaneus plate on tibia and ORIF of fibula. Both should work.

Bill Obremskey

Date: Mon, 10 Feb 2003 12:30 EST

From: Bill Burman

In the post op mortise view is there fibular shortening - which could impact the ankle joint?

See OTA BFC Lecture by Ed Rutledge.

Perhaps bilateral comparison ankle mortise views would help decide. If there is fibular shortening, additional plate fixation of the fibula may be indicated.

Bill Burman, MD
HWB Foundation