Saudi Journal of Medicine (SJM)
Volume-3 | Issue-08 | 472-476
Original Research Article
Surgical Management of Bimalleolar Fractures of Ankle in Adults
Ram Reddy V, Chandrashekhar Vemula
Published : Aug. 30, 2018
Abstract
Ankle fractures are the most common type of fractures treated by orthopedic surgeons in daily practice. Most of these fractures are complex type and difficult to manage. If not treated properly, may produce significant long-term disability and complications like pain, instability and early degenerative arthritis. Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing, and mobilization is achieved in these patients. This study was conducted at Prathima Institute of Medical Sciences, Karimnagar from January 2016 to December 2017. 40 adult patients with bimalleolar fractures of ankle who underwent open reduction and internal fixation were included in this study. Follow up was done at regular intervals of 6 weeks for minimum of 6 months. Baird and Jackson’s ankle scoring system of subjective, objective and radiographic criteria was used for the study. 24(60%) cases of medial malleolar fractures were fixed with malleolar screws, followed by cancellous screw in 4(10%) cases, tension band wiring in 10(25%) cases and K-wire in 2(5%) cases. 28(70%) cases of lateral malleolus were fixed with plate (24 with one-third tubular plate, 2 with 3.5mm DCP and 2 with 3.5mm recon plate) followed by malleolar screw in 4(10%) cases, Rush nail in 5(12.5%) cases and K wire/TBW in 3(7.5%) cases. Average time to union in our study was 10.4 weeks. However, most (80%) of the cases (80%) united by 8-12 weeks. Excellent results were achieved in 23(57.5%) cases, good results in 10(25%) cases, fair in 5(12.5%) cases and poor in 2(5%) cases. Open reduction and stable internal fixation of unstable bimalleolar ankle fractures restore the articular congruity of the ankle joint. Operative results in our study were satisfactory in 82.5% cases, with good to excellent functional outcome. Functional results were much better in younger age groups and men. Early weight bearing, and mobilization is achieved in these patients