Is to present our clinical experience in how we evaluate ankle fractures as unstable and the use of syndesmosis screw in their treatment. Since 2004–2008, 85 ankle fractures treated surgically. Of them 31 were evaluated as unstable according to:
preoperative x-rays findings intraoperative tests, and syndesmosis screw was used. We used AO-Weber classification: 14 cases type B(7 cases of B2 and 7B3), 16 cases type C(4 cases of C1 and 12 C2). Twenty-one of them were females and 10 were males. Their age rage was from 17–61 years old (Mean 42,5).The follow-up was from 6 months to 4 years(Mean 2,5 years). Syndesmosis screw was removed afters six weeks. Postoperative results were evaluated according the scoring system of Olerud and Malander. Postoperative there were 2 ankle O.A.(6,45%) due to false surgical technique. They treated by arthrodesis. The proper evaluation of the first x-ray findings of the fracture is of great importance for the proper treatmet. The syndesmosis screw is obligatory in unstable ankle fractures, in which, in combination with proper osteosynthesis preserves the ankle’s stability and viability. Ligament and bone lesions are responsible for ankle stability
If and how closed valgus osteotomy of tibia is possible to influence intra and post operative results of total knee arthroplasty. Since 1985 to 2002 196 high tibial osteotomies were performed. 57 of them were treated by T.K.A. In 21 of 196 cases diagnostic arthoscopy performed for evaluation of the lesion. All osteotomies were closed wedge. Stabilization of the knee was done with plaster clast and in 50% of cases staples used. The time interval from osteotomy to T.K.A was 2–17 years mean 8 years. Follow-up of T.K.A. was 3–20 years. Scars, patella Baja, shortens of patellar tendon increased operative time and degree of difficulty. Postoperative results of T.K.A, were evaluated according the WOMAC (pain, stiffness, function) KSS (function) KSRIS (x-ray findings) were the same with those of primary T.K.A. Postoperative complications:
11 cases decrease in range of knee movment 3 fractures of external tibial condyle 2 mechanical loosening of T.K.A skin necrosis rupture of extension complex. Intaoperative difficulties in high valgus tibial osteotomy and afterrwords in T.K.A. were increased although postoperative results were the same. This is the reason that surgical experience is the target point of the result
