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These
are simple fractures of the diaphysis of the fibula, proximal to the syndesmosis.
The .1 subgroup is associated to a rupture of the medial collateral ligament,
the .2 is associated to a fracture of the medial malleolus and the .3 subgroup
has associated fractures of the medial and posterior malleoli (Dupuytren´s
fracture). |
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Ref.
Manual of Internal Fixation:
595 - 611.
Surgeon. MS, RO, JC. |
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The
characteristic of type C is the fracture at the suprasyndesmotic level,
responsible for the rupture of the syndesmosis and for a more or less
large rupture of the interosseous membrane. The rupture of the syndesmosis
must always be reconstructed, either by direct suture or by reinsertion
of the tubercles of Chaput and Le Fort. In addition to performing the
internal fixation of the fibular diaphysis, it is advisable, almost without
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exception,
to place a tibio-fibular screw in order to protect the suture of the syndesmosis
and maintain the fibula in anatomic position to expedite the healing of
the interosseous membrane. This screw must be removed at 6 weeks because,
if it is not removed, the shear forces caused by the weight bearing may
result in breakage of the screw. If the screw is not removed and it does
not break, it will cause stiffness of the tibio-fibular joint.
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