STUDY OF SURGICAL MANAGEMENT OF MALLEOLAR ANKLE FRACTURES
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 62
Abstract
BACKGROUND Malleolar ankle fractures, including uni, bi and trimalleolar variants have become common due to road traffic accidents and sporting injuries. Theses fractures require fixation in most cases, as the entire weight of the lower limb transmits to the ankle and a sound and stable ankle is a prerequisite for normal gait. Open reduction and internal fixation with cc screws, TBW and semitubular plates, has been the mainstay of treatment for tri and bimalleolar fractures, increasingly unimalleolar fractures and syndesmotic injuries are also being treated with ORIF. Objectives- To study the functional outcome of surgically managed bimalleolar fractures of ankle in adults. MATERIALS AND METHODS A prospective study of 30 cases of malleolar fractures of ankle in adults, managed surgically by various techniques, in MediCiti Institute of Medical Sciences from June 2013 to Nov. 2015, satisfying the inclusion and exclusion criteria were studied. The functional outcome was evaluated using the Burwell and Charnley criteria. RESULTS Majority of the patients (76.7%) had good results in the current study, similar to what was observed in other series like Burwell & Charnley, Colton, De Souza et al, Beris et al. CONCLUSION Unstable malleolar ankle fractures are common due to road traffic accidents. Majority of them were caused by pronation-abduction (30%) and supination- external rotation forces (27%). Anatomical reduction with restoration of the articular congruence is essential in all intra-articular fractures.1 The operative results were satisfactory in 85% cases, with good to excellent functional outcome. Cancellous screws or malleolar screws are better in internal fixation of medial malleolus compared to Kirschner wire fixation and lateral plating was the best for fibular fractures. Functional results improve when the normal bend of the lateral malleolus is restored while plating.2
Authors and Affiliations
Ravi Teja Reddy K, Nagam Kirthi Chandra
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