N.N. Priorov Journal of Traumatology and OrthopedicsN.N. Priorov Journal of Traumatology and Orthopedics0869-86782658-6738Eco-Vector4770710.17816/vto201522354-59Research ArticlePotentialities of Minimally Invasive Osteosynthesis in Treatment of Malleolus FracturesSolodE. I-LazarevA. F-ErmolaevE. Gallove@inbox.ruCentral Institute of Traumatology and Orthopaedics named after N.N. Priorov, Moscow, Russia15092015223545920102020Copyright © 2015, Eco-Vector2015Treatment results for 71 patients with malleolus fractures are presented. In 32 patients (comparative group) surgery was performed by AO/ASIF technique after edema resolution. Thirty nine patients from the main group were operated on by our minimally invasive technique using V-shaped pins and threaded pins on the next day after admission independently on the presence of edema in the ankle joint region. All patients were operated on at terms from 1 to 3 weeks after injury. Duration of hospitalization averaged 16 and 10 days, restoration of joint function made up 6 and 2 weeks for the patients from the comparative and main group, respectively. Complications were observed only in patients from the comparative group, i.e. marginal skin necrosis in 8 (25%), inflammatory complications in 5 (15.6%), metal fixator migration in 1 (3.1%) and fracture nonunion in 4 (12.5%) patients. Outcomes were assessed by AOFAS Ankle- Hindfoot Scale. Mean point made up 90.3 in the main group and 88.6 in the comparative jnt. In the experimental part of the study the strength (tensile and shear) of 3 types of osteosynthesis for medial malleolus fracture were compared: with either 2 cannulated screws, V-shaped pin or 2 biodegradable screws of glycolized lactic acid was compared. Although the osteosynthesis of medial malleolus with V-shaped pin was the least strong it met the requirements of internal osteosynthesis.fracturesminimally invasive interventionspercutaneousosteosynthesisankle jointmalleolipinsпереломымалоинвазивные вмешательстваперкутанныйостеосинтезголеностопный суставлодыжкиспицы[1. Семенистый А.Ю. Оперативное лечение и реабилитация больных с переломами лодыжек: Дис. … канд. мед. наук. М.; 2005.][2. Thur C.K., Edgren G., Jansson K.Å., Wretenberg P. Epidemiology of adult ankle fractures in Sweden between 1987 and 2004: a population-based study of 91,410 Swedish inpatients. Acta Orthop. 2012; 83 (3): 276-81.][3. Мюллер М.Е., Алльговер М., Шнейдер Р., Виллингер X. Руководство по внутреннему остеосинтезу. М.: Ad Marginem; 1996.][4. Анкин Л.Н., Анкин Н.Л. Травматология. М.: МЕДпресс-информ; 2005.][5. Шабанов А.Н., Каем И.Ю., Сартан В.А. Атлас переломов лодыжек и их лечение. М.: Медицина; 1972.][6. Myerson M. Reconstructive foot and ankle surgery. 2nd ed. Elsevier Saunders; 2010.][7. Browner B.D. Skeletal trauma: basic science, management, and reconstruction. 4th ed. W.B. Saunders Company; 2008.][8. Фомичев М.В. Ошибки и осложнения современных способов хирургического лечения повреждений голеностопного сустава. В кн.: Материалы международного конгресса «Современные технологии в травматологии и ортопедии: ошибки и осложнения - профилактика, лечение». M.; 2004: 178.][9. Миронов С.П., Шестерня Н.А., Лазарев А.Ф., Солод Э.И., Гудушаури Я.Г., Какабадзе М.Г., Роскидайло А.С. Повреждения области голеностопного сустава. М.: Бином; 2011.][Asloum Y., Bedin B., Roger T., Charissoux J.-L., Arnaud J.-P., Mabit C. Internal fixation of the fibula in ankle fractures. A prospective, randomized and comparative study: Plating versus nailing. Orthop. Traumatol. Surg. Res. 2014; 100 (4, Suppl): S255-S259.][Guo J.J., Yang H., Xu Y., Wang G., Huang L., Tang T. Results after immediate operations of closed ankle fractures in patients with preoperatively neglected type 2 diabetes. Injury. 2009; 40 (8): 894-6.][Işik Ç., Tecimel O., Akmeşe R., Firat A., Tahta M., Bozkurt M. The comparison of plate-screw and tension band techniques in the osteosynthesis of Danis-Weber Type A and B lateral malleolar fractures. Acta Orthop. Traumatol. Turc. 2013; 47 (1): 27-31.]