A study on surgical treatment of ankle fractures- A clinical study of 21 cases

Abstract

Background : Ankle fractures are the most common significant lower extremity fractures. These fractures gain importance because the whole body weight is transmitted through the ankle, and locomotion depends on the stability of the ankle. Open reduction and internal fixation have become the main stay of treatment for most of the ankle fractures, As these operative methods restores the anatomy, biomechanics and contact loading characteristics of the ankle. Materials and Methods : The results from a consecutive series of 21 patients followed for an average period of 6 months between November2010- June 2012 that were classified according to Lauge-Hansens classification and treated according to the AO system are presented. Assessment of the outcome was done using the scoring system of Baird and Jackson which is based on subjective objective and radiological criteria. Results : Out of 21 patients treated, overall good to excellent results were obtained in 17 patients. The results were fair in three and poor in one patient . There were no intra operative complications. The postoperative complications were skin infection in two patients. Conclusions : Anatomical reduction is essential in all intra articular fractures, more so if a weight bearing joint like ankle is involved. Open reduction and internal fixation guarantee high standard of reduction besides eliminating chances of loss of reduction. The fibular length has to be maintained for lateral stability of the ankle. Chances of non union of the medial malleolus due to periosteal interposition are avoided. Poor clinical results are found to be associated with unsatisfactory surgical reduction.