A prospective observational study of surgical management of bimalleolar fractures around ankle

Abstract

Ankle fractures are one of the commonest fracture of lower limb encountered by orthopaedic surgeon. Incidence of ankle fracture has increased in both young and elderly age group; which accounts for 9% of all fractures. The incidence of ankle fractures is approximately 187 per 1 lakh person each year. Sir Robert Jones said “The least well treated and most prone joint to get injured is the ankle joint. Ankle fractures most commonly caused by fall, twisting and sport injuries. Middle and older aged patients presenting with ankle fractures have co-morbidities like diabetes mellitus and obesity. Ankle joint is most commonly injured because of its weight bearing function and role in locomotion. Ankle fracture are likely to cause lifelong complication like early degenerative arthritis, instability and pain; therefore understanding of biomechanics of ankle joint, proper fixation technique and findings of outcome studies is utmost important. Experimentally shown by Paul L. Ramsay, about 1mm lateral shift in talus, produces about 42% of decrease in tibio-talar contact area. Therefore the reduction should be ideal anatomically, which can be attained by open reduction and internal fixation. The operative procedure preserve the anatomy and weight bearing function of ankle joint and also helps in easier rehabilitation without a cast, early mobilization and weight bearing.