OUTCOME OF SURGICAL MANAGEMENT OF BIMALLEOLAR FRACTURES IN ADULTS


Krishna Bhargavevem, Anvesh Kumar Kondlapudi, Sai Pavan Kumar Murari, Srinivasa Murthy

Abstract


 

 Objectives: Appropriate management of malleolar injuries is crucial as the ankle is an important weight-bearing joint, and locomotion is determined by and dependent on joint stability. We studied the functional outcome of surgically managed bimalleolar fractures of the ankle.

Methods: Fractures were classified anatomically and as per Lauge–Hansen, arbeitsgemeinschaft für osteosynthesefragen (AO)/orthopedic trauma association classification. The stability of the structures at the fracture site, the extent of damage, mechanism of injury was assessed. Radiologically, tibiofibular clear space of >6 mm and widening of the medial clear space of >4 mm were indicators of syndesmotic instability.

All underwent open reduction and internal fixation under spinal and/epidural anesthesia. We used tension band wiring, malleolar screw, Kirschner wires (K-wires), cancellous screws for fixing medial malleolus; one-third tubular plate and K-wires for lateral malleolus. Patients were followed up at 6 weeks for 6 months, evaluated using Biard and Jackson’s ankle scoring system.

Results: Of 30 patients, 25 (83.3%) were men. The right ankle was involved in 56.6%. Road traffic accident was the cause in 83.3%. 14 (46.6%) had supination external rotation injuries. The AO Type B was the most common (66.6%). All had a complete union, with a mean time for union 10.6 weeks (8-14 weeks). Functional scores were categorized into excellent (60%), good (26.6%), fair and poor (n=02 each). Superficial and deep infection (n=02 each), delayed union (n=01) were the complications.

Conclusion: ORIF restores the articular congruity of the ankle joint. Cancellous or malleolar screws are better for fixation of the medial malleolus and lateral plating for fibular fractures.


Keywords


Bimalleolar fracture, Biomechanics, Cancellous screw, Malleolar screws, Open reduction and internal fixation, Plating, Tension band wiring.

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About this article

Title

OUTCOME OF SURGICAL MANAGEMENT OF BIMALLEOLAR FRACTURES IN ADULTS

Topics

Orthopedics; bimalleolar fracture

Keywords

Bimalleolar fracture, Biomechanics, Cancellous screw, Malleolar screws, Open reduction and internal fixation, Plating, Tension band wiring.

DOI

10.22159/ajpcr.2017.v10i11.20808

Date

01-11-2017

Additional Links

Manuscript Submission

Journal

Asian Journal of Pharmaceutical and Clinical Research
Vol 10 Issue 11 November 2017 Page: 252-256

Print ISSN

0974-2441

Online ISSN

2455-3891

Statistics

35 Views | 44 Downloads

Authors & Affiliations

Krishna Bhargavevem
Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.
India

Anvesh Kumar Kondlapudi
Department of Orthopaedics Sri Devaraj Urs Medical College, Kolar - 563 101, Karnataka, India.
India

Sai Pavan Kumar Murari
Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.
India

Srinivasa Murthy
Department of Orthopaedics, Apollo Institute of Medical Sciences and Research, Hyderabad - 500 096, Telangana, India.
India


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