Study of surgical management by internal fixation of bimalleolar fractures

Abstract

This study has been done to evaluate the effectiveness, functional results and complications following surgical internal fixation of Bimalleolar fractures of ankle joint, In this study 50 patients of fresh bi malleolar fractures of ankle joint treated surgically by internal fixation, studied between may 2017 to February 2018 in mamta general and super specialty hospital, khammam. Surgeries were performed within 5 days average. All cases treated by open reduction and internal fixation, In this study there was 19 cases of abduction, 7 cases of adduction, 16 cases with supination external rotation and 8 cases with pronation external rotation type of injuries with 80% of medial malleolar fracture are treated by malleolar screw and k- wire fixation, the other 20% by tension band wiring, most of the lateral malleolar fractures fixed with one third semi tubular plate amounting to 80% and rush nail have been used in few cases where the fracture is above the syndesmotic level. Anteriomedial approach for medial malleolus and anteriolateral approach for fibula was used in all 50 cases. All the fractures united with a union rate of 94%. Radiological union was possible in 12.2 weeks, weight bearing started from 12 weeks, early ankle stiffness noted in 4 % of cases which was overcome by good physiotherapy and full ankle motion observed in 90% patients. There were one case of non union, two cases of joint stiffness and about ten cases of superficial infections. Functional results according to criteria by Burwell et al. 82% of patients achieved good or excellent results, fair result obtained in 17.5% patient and 5% patient functional result was poor.