To determine functional and radiological outcome of various surgical modalities for treating malleolar fractures: Observational study

Abstract

Purpose: To determine functional and radiological outcome of various surgical modalities for treating malleolar fractures. Materials and Methods: The present prospective observational study was conducted among 40 admitted in the department of Orthopedics, Sir T Hospital, Bhavnagar with Ankle Fracture. Standardized clinical and functional evaluation at 2 weeks (suture removal), 3 months and 6 months were done. Surgical technique used were open reduction and internal fixation of the lateral malleolus with semi tubular plate; medial malleolus with cancellous screws or tension band wiring ; posterior malleolus with cancellous screws. Radiological assessment of each patient was done. The outcome measures were calculated using the Karlsson and Peterson functional scoring system at 3 and 6 months postoperatively. Similarly radiological outcome was calculated using Kristenson’s Radiological criteria at 6 month. Results: In our series, most of the patient affected by the fracture belongs to age group of 41- 50 years which was16 (40%). The commonest mode of injury is fall (50%) and road traffic accident (32.5%). 23 were male patients (57%) and 17 were female patients (43%). 23 cases involved the right ankle and 17 cases involved the left ankle. The mean duration of stay was 4.5days. In the present study out of 40 patients, 5 patients presented with persistent swelling, 8 patients presented with residual pain while 9 patients presented with both of the complaints In our study of 40 cases, 29 cases (72.5%) achieved good results and 7 cases (17.5%) achieve fair results and 4 cases (10%) achieved poor results at 6 months follow up.1 patients develops superficial infection postoperatively and treated by dressing and antibiotics. Conclusion: Ankle fractures are among the most common injuries treated and these are best managed by open reduction and internal fixation. Anatomical reduction is essential in all Tri-malleolar fracture to achieve good functional outcome and to avoid complications like arthritis and loss of range of movements. Immobilization for 6 weeks doesn’t reduce the final functional outcome. Good physiotherapy is recommended for adequate range.