Treatment of unilateral composite external fixator for fracture-dislocation of ankle joint with soft tissue defect

WU Haojun; CHEN Hang; CHEN Guanghua

doi:10.3969/j.issn.1674-666X.2014.05.07

Abstract：Objective To evaluate the outcome of unilateral composite external fixator for the treatment of fracture-dislocation of ankle joint with soft tissue defect. Methods From July 2008 to July 2012, 15 patients suffered from fracture-dislocation of ankle joint with soft tissue defect were treated in the Affiliated Hospital of Guangdong Medical College. All patients received emergency surgery of debridement and external fixation with unilateral composite external fixator after admission, and the open wound achieved two-stage repair. X-ray were taken for follow-up after the surgery, and at the last follow-up, function of ankle joint was evaluated by American Orthopaedic Foot and Ankle Society (AOFAS) scoring. Results The average operative time was (79 ± 24) min (40-120 min). There were stamp skin grafting in 13 cases and flap transplantation in 2 cases, and skin graft survived in all patients. The average wound healing time was(23 ± 7)d ( 17-42 d), and the average follow-up was (20 ± 6) months (12-36 months). No necrosis of skin, osteomyelitis, pin loosening or external fixation failure occurred. There were only 3 patients of mild infection of pin site or Kirschner wire who were cured shortly after symptomatic therapy. The average bone union time was (8.2 ± 1.8) months (5-11 months). According to AOFAS scoring, there were excellent in 9 cases, good in 4 cases and fair in 2 cases at the last follow-up. Conclusion For fracture-dislocation of ankle joint with soft tissue defect, unilateral composite external fixator allows for transarticular fixation, rapid wound repair, as well as early weight-bearing and functional excise..