Radiology Updates

Radiology updates

ANKLE JOINT DISLOCATION

Patient History

         H/o fall from hight RtAnkle

Examination  :- Patient unable to ambulant,with pain ,Bleeding,deformity on the Rt Ankle.open wound on the medial side of rt ankle about 10cm with exposeddistal tibia (G3A)

Radiological findings

       x-ray shows fracture dislocation at Rt ankle.

Operative steps:-

     medial ,incision extending same orfinal wound,tendon injury noticed.MM fixed with malleolor screw and K wire

LM..direct lateral incision noted at # LM

Fixed with DCP and screw

Findings:-

Rt ankle: crush wound irrigated, wound extended tibilis posterior tendone,FD tendone cut,crushedarea of tendone loss with contusion of posterial tibial nerve,

Tendones repaired using modified kissler and augmintation sutures approximated with difficulty due to area of tendone crush,loss

Medial malleolus # seen with bone loss reduced, fixed with 70mm mallelor screw amd K wire, (2), flexor retinaculam repaired and wound closed.

Fibula:-direct incision on lat malleoli severe communicated fracture lat malleoli was noted and reduction and fixation with planteand screw 7 hole small DCP with four screw proximal and 2 distal screw. Small fragment put in place with vicryl 1.wound closed b/k slab applied

Post Operative Diagnosis:

Type 3-a castillo & andreson bimaleolar # dislocation rt ankle with soft tissue crush injury.