RECHERCHES SCIENTIFIQUES

LES FRACTURES BIMALLEOLAIRES EXPERIENCE DU SERVICE DE TRAUMATOLOGIE ORTHOPEDIE DE L’HOPITAL MILITAIRE MOULAY ISMAIL DE MEKNES

Référence918
Année2015
TypeThèse
Lien document
AuteurLamgari G
DisciplineCentre Hospitalier Universitaire Ibn Sina - Rabat
EncadrantAmhajji L

The bimalleolar fractures are fractures which disrupt the clamp ankle and threaten the lateral stability of the ankle.They are frequent and occupy the 3rd place of all skeletal fractures.We conducted a retrospective study in 61 patients, from January 2008 to December 2013, the Traumatology-orthopedics service at the military hospital inMeknes, we were able to clarify the epidemiological characteristics of our patients, give the medium-term results, and identify prognostic factors.The age of our patients was between 15 and 79 years with a mean age of 42.27 years. The bimalleolar fractures have affected all age groups particularly with a peak incidence between 20 and 40 years (42.62%). the man was reached that the woman, a sex ratio = 1.25, the most dominant causes are accidents of public roads (65.5%). and falls (26.1%). We noted the predominance of fractures supination rotation external (49.18%) as classified by Lauge Hansen. A tibiofibular diastasis was observed in 8.19% of cases. A dislocation or subluxation tibiotalar in 16.39% of cases. The skin incision was observed in 8.19% of cases.Surgical treatment in our study was indicated in 83.60% of patients. The fixation of the lateral malleolus consisted of bone plate in 68% of cases. The fixation of the medial malleolus consisted of a single screw in 58% of cases. The results are evaluated according to the criteria VIDAL: 59% good results. Comparing our results to published data confirms benefits of surgical treatment by keeping all the benefits of orthopedic treatment.The complications are dominated by infection, osteoarthritis, nonunion, and mal union The prognostic and predictive factors of long-term osteoarthritis include age advanced, severe lesions of the syndesmosis (often encountered in fracture pronation abduction), cutaneous openness, tibiotalar dislocation and delay treatment.Rehabilitation therapy remains an indispensable complement whose neglect can increase the risk of serious complications from treatment more difficult and detrimental impact on the ankle