Prevention of injury of the large subcutaneous vin in the development of initial signs of venous insufficiency with operational access to the inner ankle

Kukushkin Evgeni Petrovich, Midlenko Vladimir Ilyich, Midlenko Oleg Vladimirovich

Purpose of the study: to evaluate the effectiveness of the proposed method with operative access to the inner ankle in order to prevent damage to the great saphenous vein in the development of the initial signs of venous insufficiency. Materials and Methods: We observed 198 patients with closed ankle fractures who were operated on at the Zakharyin Clinical Hospital No. 6 in the city of Penza from 2016 to 2018. The patients were divided into 2 groups: 1 group of 95 patients with iatrogenic injury of the great saphenous vein; 2 group of 103 patients without iatrogenic damage to the great saphenous vein, where the author's technique was used. In all the patients we observed in the postoperative period, the development of the initial signs of venous insufficiency was assessed. Results of the study: In patients operated on for fractures of the ankles, in the case of iatrogenic damage to the great saphenous vein in the postoperative period, initial signs of venous insufficiency develop, which was confirmed clinically and by data from instrumental studies. When using the author's technique, the great saphenous vein was not damaged, as a result of which venous insufficiency did not develop. Findings: 1. Iatrogenic injury of the great saphenous vein during surgery for ankle fractures leads to the development of the initial signs of venous insufficiency in the postoperative period. 2. The use of the author's technique in 100% of cases prevents damage to the great saphenous vein during operative access to the inner ankle, as a result of which the initial signs of venous insufficiency do not develop.

Keywords:venous insufficiency, saphenous vein, ankle fracture.