Functional outcome after lag screw fixation of lateral malleolar fractures

Abstract

A total of 27 patients were retrospectively reviewed following lag screw fixation alone of their fractured lateral malleolus. Mean follow-up was 4.3 years. Assessment was carried out using the functional score of Olerud and Molander. Forty-five percent of injuries occurred in footballers aged <30 years, all of who made an excellent functional recovery. No loss of fracture reduction occurred in any patient. All patients were routinely mobilised weight bearing in cast at 3 weeks without adverse effect. Associated ankle injuries such as fracture dislocations, medial malleolar fractures or syndesmotic injury are shown not to be a contraindication. A ratio of fracture length to fracture width of greater than 2:1 is found in 90% of all fractures. Intra-operative assessment of fracture stability after lag screw fixation should determine the need for additional hardware. Increased patient age or associated ankle injuries are not contraindications to this technique.