Abstract
Introduction: Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury. Methods: Cross sectional study of 32 patients diagnosed with ankle fracture and undergone open reduction and internal fixation with arthroscopic assessment performed stimultaneously. The mechanism of injury, patterns of injury and intraarticular chondral injury were documented. Results: Mean age was 38 years (SD = 14.1, range 18 - 68 years). Eighteen were female and 14 were male. Fifteen involved syndesmostic distruption, 22 had Danis-Weber B injury and 16 had supination external rotation (SER). Ten (31.2%) had positive intraoperative cartilage injury. Significant correlation between the Lauge-Hansen classifications with positive findings with 6 had SER, 2 had pronation adduction and 2 had pronation external rotation. Conclusion: The prevalence of chondral injury in ankle fracture was quite high and may leads to poor outcome. Arthroscopy procedure allow surgeon to assess intraarticular surface and reduction of the ankle fracture which prompt further intervention that may improve the clinical outcomes and prognosis of the patients.
Highlights
Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury
A cross sectional study was conducted from April 2017 until December 2018 involving all patients diagnosed to have malleolar fracture that presented to Orthopaedics department of Hospital Raja Perempuan Bainun in Perak, Malaysia which is unstable and need surgical intervention as decided by doctors in charge of the patients including closed fracture of lateral malleolus, medial malleolus, bimalleolar and trimalleolar with or without subluxation and any undisplaced fracture that might displaced once the swelling reduced
There were 32 patients involved in this study with mean age was 38 years (SD = 14.1, range 18 - 68 years)
Summary
Besides fracture malunion, undiagnosed syndesmosis injury and associated ligamentous or chondral lesions may lead to the poor surgical outcome. This may arise from limitation of preoperative radiographs and intraoperative fluoroscopic stress view in addressing the syndesmosis disruption and ligamentous tear [4]. Despite after good fixation and well united fracture, sometime patients still have pain with limitation of functions This give rise to the concern of whether the diagnosis is exact and proper treatment has been given [12]. This study was conducted to determine the prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury
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