Surgical Outcome of Closed Bi-Malleolar Fracture in adult, Bangladesh Perspective

Abstract

Treating of ankle injuries is challenging due to swelling, risk of infection and skin necrosis in the postoperative period. After subside of swelling closed displaced bi-malleolar fracture in adult. Above the age of 18 years are treating with a one-third tubular plate for lateral malleolus and distal threated cancellous screw or tension band wiring for medial malleolar fracture, which can be evaluated clinically and radiologically. This multicenter, nonrandomized, experimental comparative study has been carried out in Rajshahi Medical College Hospital, Rajshahi and Sador Hospitals Joypurhat in Bangladesh. From June 2017 to December 2020 in this study. Total 30 patients were split into two groups: 'A,' consists of a one-third tubular plate and distal threaded cancellous screw and another group 'B' ORIF with Small DCP or one-third tubular plat with tension band wiring for medial malleolus. The mean surgery injury interval was 11.6 days. The mean hospital stay was 4.2 days. We have an assessed all patients with The Olerud C and Molander H functional score system. There were excellent practical results in 11 cases in the partially threaded vice with one-third tubular plate (73.3 percent), In 3 cases good (20%), in one case fair (6,7%) good. There were also very good functional results in 6 cases (40%), good (5%), fair in 4 cases in tension bowing wiring with one-third tubular plate (26.7 percent). The p-values were >0.05. We have classified all patients with the Danis-Weber classification system, operated Type A, B, and C categorized patients. We have used a syndesmotic screw in10 patients that have been removed at the end of 12 weeks. All implants were removed within 2.5 years in both groups. Both the operational techniques used in the study produce excellent union rates and functional results. The study was limited in samples small and lacked long-term follow-ups in both groups.