Science & Healthcare

Relevance: Ankle fractures are among the most common injuries of the lower limb. The greatest difficulties in their treatment are multi-ankles fractures with a dislocation of the foot. Transarticular spinal fixation attracts by the ease of holding, by the stability of the joint. However, the complications associated with the incorrect position of the locking spokes are likely. The device for exact carrying out of spokes promotes creation of conditions for stable fixation and reduction of frequency of complications.

The purpose of the study was to improve the technique of carrying the spokes for transarticular fixation in the case of ankles fractures accompanied by dislocation of the foot.

Materials and methods: 142 patients were examined, including 87 men (61,3%) and 55 women (38,7%) aged 19 to 75 years (mean age 46,1 ± 2,5 years). The main subgroup included 97 patients who used the developed device during the treatment. In the comparison group, there were 45 people (31,7%) who held the locking spokes without using the device. An assessment was made of the course of early (inpatient) and long-term (out-patient) treatment periods for patients in both groups, taking into account the frequency and structure of complications, the duration of treatment and its functional outcomes. Statistical analysis of the frequency indexes was carried out using the Pearson χ2 criterion and the exact Fisher test (for n <10 in any of the selected subgroups). Continuous indicators were analyzed using parametric (Student's t-test) and nonparametric (Mann-Whitney test) methods.

Results: The incidence of complications in the main group was 5,5 times lower than in the comparison group, and the number of people with complications in the comparison group was 22 (48,9%), in the main group - 10 (10,3%), the differences were 4,7 times.

The duration of inpatient treatment in the main group was 2,8 days less than in the comparison group (19,4%, p=0,03), outpatient treatment by 19,9 days (15,4%, p=0,02).Substantially higher in the main group was the frequency of excellent results (by 45,6%, p=0,02). Satisfactory results were 4,3 times more frequent in the comparison group (p=0,03).

Conclusion: The use of a device to accurately hold the spokes provides a significant improvement in the results of treatment of ankle fractures using transarticular fixation.