title: [Indications for surgical management of lower leg fractures].
abstract: A follow-up series of 324 lower leg fractures treated between 1980 and 1985 in a regional hospital showed overall good results. Besides a non-union-rate of 0% there were also low values for infection (3.7%), re-fracture (2.16%), delayed healing (4.63%) and thrombosis (3.42%). Many reasons are dealing with that. First of all, most of our patients were young, active people, who sustained their injuries during ski-accidents with a high amount of torsional-type lesions (A1, B1, C1; Johner/Wruhs-scheme). The second important point was, to use a simple, quick and safe method with the possibility of a short hospital stay and good final outcome, managing the high frequency of victims, admitting the trauma unit in the late afternoon after closure of ski-lifts. Finally, one has to realize, that most of our patients had been treated by one surgeon, who has a lot of experience with the aforementioned methods. We can state finally, that percutaneous cerclage-wires (Götzes method) will be used for spiral fractures, occurring in the second to fourthfifth, in future, too. Bending-type fractures with one or more butterfly-fragments (B2, B3) and segmental fractures (C2), should be treated by interlocking nailing. Only fractures with severe closed soft tissue injuries or open fractures (grade II-III-Tscherne), will be managed by an external frame. Compression plates should only be used for fractures in the first or fifth fifth with articular lesions.
authors.affiliation: Unfallabteilung des Allgemein öffentlichen Bezirkskrankenhauses Schwaz/Tirol.
authors.forename: H
authors.initials: H
authors.lastname: Habernek
authors.forename: G
authors.initials: G
authors.lastname: Walch
authors.forename: M
authors.initials: M
authors.lastname: Dengg
authors.forename: C
authors.initials: C
authors.lastname: Dengg
mesh_terms: D000328:Adult; D001858:Bone Nails; D001860:Bone Plates; D001864:Bone Wires; D005260:Female; D005360:Fibula / Q000293:injuries*; D005592:Fracture Fixation / Q000379:methods*; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011859:Radiography; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*
vernacular_title: Zur Indikationsstellung der operativen Behandlung der Unterschenkelfraktur.