Übersetzt aus dem Englischen:
Lerne den Knöchelbruch: Laterale Malleolar-Fixation mit der operativen Technik des Acumed Fibula Rod System mit Schritt-für-Schritt-Anweisungen auf OrthOracle. Unsere E-Learning-Plattform enthält hochauflösende Bilder und eine zertifizierte CME des Knöchelbruchs: Laterale Malleolar-Fixation mit dem operativen Verfahren des Acumed Fibula Rod System.
Die meisten Knöchelbrüche sind stabil, was bedeutet, dass unter physiologischer Belastung die Hauptstabilisierungsstrukturen des Sprunggelenks ausreichend in der Lage sind, ihre Funktion zu erfüllen. Daher werden stabile Knöchelbrüche in der Regel konservativ behandelt. In den verbleibenden Fällen kann die Stabilität verschiedenen Strukturen durch verschiedene Methoden verliehen werden. Die Wahl der Fixierung wird von verschiedenen Faktoren beeinflusst, von verfügbaren Ressourcen und chirurgischen Vorlieben bis hin zu Faktoren, die durch die Pathologie bestimmt werden, mit der der Chirurg konfrontiert ist. Diese Faktoren werden oft nicht nur von der Qualität des Knochens wie dem Grad der Trümmerbildung oder Osteoporose beeinflusst, sondern auch von den Auswirkungen der Verletzung auf die Weichteilhülle. Das Acumed Fibula Rod System (FRS) bietet dem Chirurgen eine zusätzliche, bewährte Behandlungsoption mit Vorteilen gegenüber offenen Techniken für diejenigen mit schlechter Knochenqualität und Weichteilhülle.
Ankle fracture: Lateral malleolar fixation using Acumed Fibula Rod System
Diese enthält eine sehr detaillierte Serie von Bildern und Anweisungen zur Erläuterung der Rekonstruktion des Deltabands unter Verwendung einer Knochentunneltechnik mit dem Arthrex Internal Brace-Implantat.
Original Intro:
Ankle fracture: Lateral malleolar fixation using Acumed Fibula Rod System
Mark Herron FRCS
OrthOracle, London, UK.
Learn the Ankle fracture: Lateral malleolar fixation using Acumed Fibula Rod System surgical technique with step by step instructions on OrthOracle. Our e-learning platform contains high resolution images and a certified CME of the Ankle fracture: Lateral malleolar fixation using Acumed Fibula Rod System surgical procedure.
Most ankle fractures are stable meaning that, under physiological load, the key stabilising structures of the ankle joint remain sufficiently able to perform their function. Therefore, stable ankle fractures are, by and large, managed non-operatively. In the remainder, stability can be conferred to various structures by a variety of methods. Factors that govern the choice of fixation range from available resources and surgical preference to factors determined by the pathology facing the surgeon. These factors are often influenced not only by the quality of the bone such as the degree of comminution or osteoporosis, but also by the effects of the injury to the soft tissue envelope. The Acumed Fibula Rod System (FRS) offers the surgeon an additional, proven treatment option with advantages over open techniques for those with poor quality bone and soft tissue envelope.
The deltoid ligament is composed of superficial and deep components which are confluent with each other. The superficial part of the deltoid is the main restraint to ankle and hindfoot valgus and the deep component resists external rotation. Anatomically, the superficial deltoid runs from the medial malleolus as a fan-shaped structure its’ described components being the tibionavicular, tibiospring, tibiocalcaneal and plantar calcaneonavicular. The deep component of the deltoid also takes origin from the tip of the medial malleolus, though inserts in two bands, both into the talus, the anterior tibiotalar and the posterior tibiotalar.
When a bone breaks, the skin is subjected to large strains and the dermo-epidermal junction shears giving rise to fracture blister formation. This occurs most frequently in anatomic sites where a bone lies subcutaneously and is more pre-disposed in any co-morbidity that impedes wound healing. Blisters can be clear or haemorrhagic with the latter indicating more severe injury to the dermis. The definitive management of fracture blisters with regards timing of surgery and whether to aspirate, incise through or leave well alone is not clear from the literature.
In an era of an ageing population, surgeons face difficult decisions about how to confer stability to the skeleton with appropriate rigid internal fixation. This case illustrates the various dilemmas facing surgeons in making and performing surgical treatment plans in an elderly patient with a poor soft tissue envelope. The case features the decision-making steps in using the Acumed Fibula Rod System (FRS) as the definitive treatment option for a fracture of the lateral malleolus in a patient with poor quality bone and significant compromise to the soft tissue envelope.