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Syndesmotic lesion in fracture-dislocations of the ankle - Maisonneuve fracture
Fojtík, Petr
;
Naňka, Ondřej
(advisor) ;
Hromádka, Rastislav
(referee) ;
Skála-Rosenbaum, Jiří
(referee)
A Maisonneuve fracture (MF) is a fracture dislocation of the ankle caused by external rotational force. In the traditional concept it includes a subcapital fracture of the fibula, an injury to the tibiofibular syndesmosis and to the interosseous membrane, and it is considered as an unstable injury. The experimental (anatomical) goal of the dissertation work was a detailed study of the incisura fibularis tibiae (IFT), its maximum depth and its localization relative to the articular surface of the ankle. The second experimental goal was a detailed description of the lateral surface of the distal fibula, where there is a prominent but still nameless edge that gives the distal fibula its typical triangular shape on a transverse section (workingly we called it lateral malleolar crest, LMC). Both of these structures are extremely important in the diagnosis and treatment of ankle fractures. The clinical part of the work included an overview of all the literature devoted to MF and further analysis of our group of patients with MF with a focus on the posterior malleolus (PM) fracture. Anatomical studies were performed on 352 dry bone specimens of adult tibiae and fibulae. The clinical study was conducted on a group of 100 patients with MF in adult patients treated at The Department of Orthopedics, 1st...
Detailed record
Posterior malleolar fractures of the tibia in fracture-dislocations of the ankle
Kostlivý, Karel
;
Bartoníček, Jan
(advisor) ;
Pilný, Jaroslav
(referee) ;
Dráč, Pavel
(referee)
The dissertation deals with fractures of the posterior malleolus of the tibia in ankle fractures. There is no consensus on the issue in the diagnosis and treatment of tibial posterior malleolus fractures in ankle fractures worldwide. The experimental part of the study focused on the anatomy of the ankle joint, especially on the construction of the fibular incisure of the distal tibia as one of the key areas for ankle stability. The result was the determination of the ideal distance for the correct assessment of the position of the fibula in the incisure of the tibia. In the clinical part of the study, the pattern of the fractures was evaluated on a basic group of patients with ankle fractures with concurrent tibial posterior malleolus fracture using preoperative X-ray and CT examination. This made it possible to determine the basic morphological types of posterior malleolus fractures. The resulting classification was verified on an extended group of patients. In clinical practice, it was used to choose the surgical approach and method of fixation. The correctness of the resulting classification was verified on an extended group of patients. The clinical application of the anatomical 3D CT classification achieved a good anatomical position by direct reduction and stable osteosynthesis from the chosen...
Detailed record
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