ABSTRACT
PURPOSE: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. MATERIALS AND METHODS: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. RESULTS: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. CONCLUSION: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.
Subject(s)
Humans , Ankle , Ankle Fractures , Ankle Joint , Arthritis , Follow-Up Studies , Foot , Hand , Methods , Range of Motion, Articular , TibiaABSTRACT
PURPOSE: To analyze the long term follow up results of treatment with posterolateral approach and to investigate its usefulness in the patients of trimalleolar fracture with posterior fragment which is above 25% of articular involvement. MATERIALS AND METHODS: There were 34 cases of trimalleolar fracture in our hospital from May 2004 to April 2008. We investigated 20 patients who underwent operation with the posterolateral approach and over-2 years follow up cases. The mean follow up period was 34 (24~58) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in all cases and displaced more than 2 mm in 11 cases. We analyzed the radiologic type of posterior malleolar fragments and evaluated the function and pain through AOFAS score and complications. RESULTS: All cases showed primary union at mean 13.1 weeks. The complications are that partial ankylosis result of soft tissue contracture is seen in 2 cases (10%) and post-traumatic arthritis is seen in 1 cases (5%) and 17 cases (85%) of all patients are showed excellent AOFAS score. CONCLUSION: The posterolateral approach is a valuable method because that it enables us to easily reduction and internal fixation of the posterior malleolus and lateral malleolus at one time and the results are satisfied for a long time follow up.
Subject(s)
Humans , Ankle Joint , Ankylosis , Arthritis , Contracture , Follow-Up StudiesABSTRACT
PURPOSE: We wanted to evaluate the effectiveness of posterolateral approach for open reduction and internal fixation of posterior malleolar fragment with trimalleolar fracture of ankle joint. MATERIALS AND METHODS: There were 27 cases of trimalleolar fracture in our hospital from Jan. 2005 to Dec. 2007. We investigated 10 patients who underwent operation with the posterolateral approach. The mean follow up period was 20 (6-36) months. Preoperative posterior malleolar fragment involved above 25% of articular surface in 10 cases and displaced more than 2 mm in 4 cases. We analyzed the radiologic type of posterior malleolar fragments and complications, and evaluated the AOFAS score. RESULTS: All cases showed primary union mean 11.8 (8-14) weeks. The complication focal skin necrosis in one case and all patients showed excellent AOFAS score. CONCLUSION: The posterolateral approach may be a useful for open reduction and internal fixation of posterior malleolar fragment with trimalleolar fracture, especially simultaneous management of lateral malleolar fracture.
Subject(s)
Humans , Ankle Joint , Follow-Up Studies , Necrosis , SkinABSTRACT
Irreducible fracture dislocation of the ankle associated with comminuted displaced fracture of posterior malleolus is rare. Locked posterior malleolar fragments interfere with reduction of fibula or talus in ankle fractures. Prompt recognition and appropriate surgical approaches are necessary to achieve anatomical reduction of the ankle fractures.