Authors
Agafonova A.A.1, Dorokhin A.I.1, Krupatkin A.I.1, Khudik V.I.2, Karpovich N.I.3, Pimanchev O.V.4
1 Priorov Central institute for Trauma and Orthopedics, Moscow
2 Moscow’s Healthcare Department Children Hospital of Z.A. Bashlyaeva, Moscow
3 RUDN University, Moscow
4 Pirogov National Medical and Surgical Center, Moscow
Abstract
Backgraund: The greatest challenge in diagnosis and selection of the optimal treatment method are Tillaux and triplane fractures. Computed tomography cannot to be a screening test for ankle injuries due to the high radiation exposure and limited availability on an outpatient basis. Sonographic examination is a safely method, does not require patient transportation, and allows damage in real time. Non-invasive methods are use to study regional blood supply.
Aims: Ultrasonic modifiers to developed for Tillaux and triplane fractures of the distal tibia in children with assessment of microcirculatory activity in the area of injury in the postoperative period.
Materials and methods: We performed a prospective, open-label study of patients aged 11 to 14 years with triplane and Tillaux fractures. The total number of patients is 70 people. Ultrasound examination of the ankle joint was performed in all patients. The mechanism of injury was assessed according to the Lauge-Hansen classification. laser Doppler flowmetry method was used over a period of 4 to 6 weeks. The rate of the regenerative process was assessed in 20 patients.
Results: These populations had criteria of homogeneity with little variation. The following ultrasonic damage modifiers were identified: isolated two-part triplane fracture with an intact or partially damaged anterior part of the distal tibiofibular syndesmosis, isolated Tillaux fracture with an intact or damaged anterior part of the distal tibiofibular syndesmosis, three- and four-part triplane fracture with partial damage or rupture of the anterior part of the distal tibiofibular syndesmosis, Tillaux fracture with an ipsilateral fracture of the fibula, complicated by a partial or complete rupture of the distal tibiofibular syndesmosis, a triplane fracture with an ipsilateral fracture of the fibula, complicated by a partial or complete rupture of the distal tibiofibular syndesmosis.
Conclusions: The known classification characteristics of typical fractures are supplemented by damage to soft tissue structures. The laser Doppler flowmetry method made it possible to assess the microcirculatory activity of the injury in the postoperative period.
Keywords: ultrasonography, ankle fracture, Tillaux fracture, child, laser Doppler flowmetry.
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