Spiral and oblique fractures of distal one-third of tibia-fibula: treatment results with circular external fixator.
BACKGROUND
Spiral and oblique fractures of distal 1/3 of tibia-fibula are relatively common fractures of long bones. Due to their types, aetiology, limited coverage and blood supply, these fractures often lead to union and soft tissue problems.


METHODS
Twenty-seven patients with spiral and oblique fractures of distal 1/3 of tibia-fibula were treated with circular external fixator (CEF) between January 1997 and August 2000. All the fractures were closed. The type of fractures based on AO classification were A1 (n = 8), A2 (n = 6), B1 (n = 11) and C1 (n = 2).


RESULTS
The mean framing time was 14.1 +/- 1.8 weeks (range, 12 to 19 weeks), and the mean treatment time was 18.8 +/- 2.2 weeks (range, 15 to 24 weeks). The patients were followed up for 36 to 78 months (mean follow-up time: 51.9 +/- 10.4 months). The results were evaluated for shortness, angulation, rotation, ankle stiffness, pain and infection. After removal of the frames, 11 patients had ankle pain and stiffness, and 3 patients had loss of range of motion in the ankle even after rehabilitation. None of the patients suffered any complications such as shortness, angulation, rotational deformity and infection, and none had loss of motion in the knee.


CONCLUSIONS
CEF might be a preferable alternative treatment for distal tibia-fibula fractures due to its easy application, fewer major complications such as shortness and angulation, early mobilisation and shorter treatment time.
Demiralp
Bahtiyar
B
Faculty of Medicine, Department of Orthopaedics and Traumatology, Gülhane Military Medical Academy, Ankara, Turkey. bahtidemiralp@yahoo.com
Atesalp
Ali Sabri
AS
Bozkurt
Murat
M
Bek
Dogan
D
Tasatan
Ersin
E
Ozturk
Cagatay
C
Basbozkurt
Mustafa
M
D000058:Accidental Falls; D000063:Accidents, Traffic; D000328:Adult; D000368:Aged; D001265:Athletic Injuries; D016267:External Fixators; D005260:Female; D005360:Fibula / Q000293:injuries / Q000601:surgery*; D050723:Fractures, Bone / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D017759:Fractures, Malunited / Q000601:surgery*; D006801:Humans; D018889:Ilizarov Technique; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D016059:Range of Motion, Articular; D013978:Tibial Fractures / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D014421:Turkey