Functional outcome of bimalleolar ankle fractures treated with fibular plate for lateral malleolus and C.C. screws for medial malleolus

Abstract

Background: Malleolar injuries are the most common significant lower extremity fractures. These injuries 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 mainstay of treatment for most of the unstable bimalleolar fractures, as these operative methods restores the anatomy, biomechanics and contact loading characteristics of the ankle.Objectives:1.To study the functional outcome of surgically managed bimalleolar fractures of ankle in adults.2.To restore the anatomy of malleoli and ankle perfectly by operative treatment with internal fixation Methods: A prospective study of 50 cases of bimalleolar fractures of ankle in adults, managed surgically by screw for medial malleolus and plate for lateral malleolus during the period from june 2018-feb 2020 at Dr. D.Y. Patil hospital, Navi Mumbai.Inclusion Criteria•All closed fractures.•Open type 1, 2, 3a (Gustillo-Anderson).•Above 18 years.Exclusion Criteria•With associated Pilon fracture.•Patients unfit for surgery.•Patients with minimally displaced mono-malleolar fractures, avulsion fractures and stable fracturesFollow-up was taken at 1month, 3 months, and 6 months post-operatively. At every visit check radiographs were taken to assess the radiological union.Results: In our study we achieved 86% excellent to good results, 8% fair results, 6% poor results. The results were comparable to other studies.Conclusions: The operative results were satisfactory in 86% cases, with good to excellent functional outcome.•Excellent results are obtained with stable fixation of fracture. Cancellous screws or malleolar screws are better in internal fixation of medial malleolus and lateral plating was the best for fibular fractures.•Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing and mobilisation is achieved in these patients.Anatomical reduction with restoration of the articular congruence is essential in all intra articular fractures, more so, if a weight bearing joint like ankle is involved. Open reduction and internal fixation restores the articular congruity of the ankle joint.