Diagnosis and treatment of the tibia shaft fracture accompanied with ipsilateral posterior malleolus fracture

Abstract

Objective To discuss the cause and prevention of the tibial shaft fracture associated with ipsilateral posterior malleolus fracture. Methods From May 2001 to November 2004, 269 cases of tibial shaft fracture were treated in our department. Of them, 34 were complicated with ipsilateral posterior nialleolus fracture. They were 21 males and 13 females. Their ages ranged from 33 to 71 years old. There were 2 patients with tibial open fracture. Preoperatively conventional plain X-ray of the full-length tibia and ankle region was taken for all the patients. CT scanning was conducted for those who were suspected of the ipsilateral posterior malleolus fracture. Before tibial intramedulary nailing, the posterior malleolar fragments were fixed with an anterior lag-screw. Results The mean duration of follow-up was 11 months. The posterior malleolus fracture healed with excellent ankle function in 33 cases. The only one case whose posterior malleolus fracture had been overlookd until follow-up sufferd from ankle disfunction and pain. Conclusions The tibial shaft fracture is frequently complicated with and the ipsilateral posterior malleolus fracture in clinic which is re-sponsible for the ankle disfunction. Pre-operative CT scanning of the ankle and fixation of the fragments are key elements of the prevention. Key words: Tibial fracture; Ankle injuries ; Fracture fixation, intramedullary