KUMJ | VOL. 17 | NO. 2 | ISSUE 66 | APRIL-JUNE 2019
Operative Outcome of Bimalleolar Fractures
Dhoju D
Abstract: Background
Ankle fractures are common injury occurring due to low energy trauma. Unstable
ankle fractures are usually treated with operative management.
Objective
To find out demographic and the relationship between various clinical variables
and outcome of operative treatment in ankle fractures in patient who underwent
operative treatment for bimalleolar ankle fractures.
Method
A retrospective observational study of 32 patients who underwent operative
treatment of bimalleolar ankle fracture in between January 2012 and December
2015 at Dhulikhel Hospital, Kathmandu University Hospital was performed. Skeletally
mature individual of age greater than 16 years with bimalleolar ankle fractures
operated within two weeks of injury were included in the study. Operating surgeon
chose the type of surgery and implants required for the patient. Post operatively
patients were kept in non-weight bearing for six weeks.
Result
The average age of the patients was 36.72 ± 19.97 years. The most common cause
for the injury was twisted ankle. The mean follow up period of the patients was 20.94
± 16.32 months. The most common fracture type was Weber B (supination external
rotation injury). Most common technique for fixation for medial malleolus fracture
was open reduction and modified tension band. Most of the lateral malleolus
fractures were treated with open reduction and fixation with reconstruction plate.
Six cases were treated with syndesmotic screws. Most of the patients had excellent
AOFAS score with mean score of 90.56 ± 10.92 out of maximum 100. Average pain
score was 32.81 ± 36.34 out of 40, average function score was 47.81 ± 6.05 out of 50
and average alignment score was 9.94 ± 0.35 out of 10.
Conclusion
The outcome of surgically treated bimalleolar ankle fractures was excellent for our
patients. The fracture patterns and requirement of syndesmotic screw failed to show
any significance when comparing the outcome.
Keyword : Ankle, American Orthopedic Foot and Ankle Society Score, Bimalleolar fractures