Application and evaluation of posterolateral approach in displaced lateral and posterior malleolar fractures

Abstract

Objective To evaluate the posterolateral approach used in the surgical management of displaced lateral and posterior malleolar fractures. Methods From March 2005 to August 2007, 23 patients with displaced lateral and posterior malleolar fractures were treated by open reduction and internal fixation (ORIF) through the posterolateral approach. The posterior anti-glide plate was used to assist the re-duction of lateral malleolar fractures, while traditional lateral plates or screws were used for posterior malleolar fractures. Postoperative wound healing, union of fractures and condition of internal fixation were measured and recorded. The Olernd and Molander scoring system was used to evaluate the functional recovery of the ankle joint. Results All the patients were followed up for 6 to 23 (average, 15) months. No dehiscence or necrosis of the wound was found. One patient suffering from superficial infection 10 days after surgery was treated with debridement and antibiotics. One patient presented with postoperative symptoms of peroneal nerve injury which were relieved naturally 3 months later. One patient presented with mild postoperative symptoms of peroneal tendinitis which subsided after hardware removal following fracture union. The X-rays 4 to 6 months after surgery showed all fractures united without loosening or rupture of the internal fixators. Functional recovery of the ankle joint scored 91 points on average, with an excellent to good rate of 95.6%. Conclusions As the posterolateral approach can be used to treat the displaced lateral and posterior malleolar fractures simultaneously, it provides an alternative for treatment of ankle fractures. Key words: Ankle jiont; Fracture; Fracture fixation, internal; Posterolateral approach