Critical comments invited for already posted case
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Bhupesh Mahawar Very nice fixation….
Did u open d joint 4 articular reduction. .? Bcz it looks 2 good. -
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Kir Pat Good mgmt.,principle fix..antiglide..preop-CT/MRI done?as to view intermediate coln.frg is there .and for prognosis tibiotalar cartilage assesment ..Syndesmosis ? -
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Javed Jameel CT/MRI not done…
Joint not opened
Syndesmosis stable …
Lateral skin was bad for any open procedure -
Michael Dujela Weber B with supination adduction pattern would almost never require syndesmosis screw. I have seen it maybe once in a mixed pattern injury -
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Kir Pat It,s well managed case. but better and prognostic functional forecast,Michael Dujela, it is not pattern of injury ,this is not classified weber one, but what worrisome is synd lig avulsion at t/f joint may be intraarticular needs to be assesed by CT/MRI also doubt of osteochondral to be adressed ..frg clearly seen at lateral tibial plafond.
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Michael Dujela I don’t worry too much about an isolated AITFL avulsion as it contributed to about 20 percent of syndesmosis stability with PITFL and IOL most likely remaining. Agree with CT need Kiran Patel. I routinely do arthroscopy in a case like this at the beginning of the procedure
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Sanjai Kumar Srivastava Fibular fracture is below syndesmosis. How syndesmotic screw is going to help??. If skin conditoon had allowed A TBW of Lat mal or Locked plate on fibula was welcomed.
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Gaur Gautam Kar Absolutely fine osteosynthesis. Syndesmosis was intact so why put a screw… this is a supin-add injury where the tension side (lat) often has really bad soft tissues so plating is not to be done. -
Iqrar Raja fibula plating-low profile medial tibial plating Mippo. as a butteress wit a syndesmotic screw only if distal tibio fibular joint distance increases on dorsiflexion after fixation intra op-with due respect to the soft tissue