title: [Fracture of the distal lower limb: two-stage surgical treatment with external fixator and locked-screw plate].
abstract: From January 1999 until October 2004 we treated 42 patients with closed fractures of the distal calf by a two-stage treatment plan: first the fracture was stabilized with an external fixator bridging the ankle joint. Second, after an average period of 8.3 days, an open reduction and internal fixation with a locked-screw implant followed. As complications we saw a superficial wound necrosis in 3 cases, 2 patients needed an early bone graft after insufficient bone healing and in one case a deep vein thrombosis of the thigh occurred. A deep infection or osteitis were not seen. 17 patients showed no deficit in the range of movement of the ankle joint compared to their opposite side, 21 patients had a deficit of movement of one third compared to the opposite side and 4 patients suffered from a deficit of (2/3). Radiologically we saw in 31 fractures of the pilon-tibiale in 19 cases no or only few arthrosis of the ankle joint, in 9 cases intermediate and in 3 cases advanced arthrosis. With a two-stage surgical treatment with external fixator and locked-screw implant we achieved a good functional result with only few complications.
authors.affiliation: Berufsgenossenschaftliches Unfallkrankenhaus, Abteilung für Unfall- und Wiederherstellungschirurgie, Hamburg. Christian.Queitsch@kliniken-pinneberg.de
authors.forename: C
authors.initials: C
authors.lastname: Queitsch
authors.forename: B
authors.initials: B
authors.lastname: Kienast
authors.forename: S
authors.initials: S
authors.lastname: Fuchs
authors.forename: K
authors.initials: K
authors.lastname: Seide
mesh_terms: D000328:Adult; D016512:Ankle Injuries / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D001860:Bone Plates; D001863:Bone Screws; D004867:Equipment Design; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology; D012086:Reoperation; D013978:Tibial Fractures / Q000145:classification / Q000000981:diagnostic imaging / Q000601:surgery*