Study of surgical management of malleolar fractures of ankle in adults

Abstract

Background: Ankle fractures are one of the most common fractures encountered in the emergency and are among the most common injuries treated by orthopaedic surgeons. Operative treatment is indicated when congruity of the joint cannot be restored with closed methods. The postoperative period and the protocol of mobilization of the ankle has been a topic of conflict. Purpose: A thorough understanding of the ankle anatomy, mechanism of the injury, interpretation of the radiographs and adherence to basic principles of fracture management are the basis for a good result. So, the purpose of this study was to assess functional outcome of surgery in ankle fractures. Method: A prospective study was conducted from August 2013 to May 2015 on all patients in age group 20 to 65 years reporting to the hospital with malleolar fractures. Total 36 patients recruited for the study all were surgically treated in Poona Hospital and Research Center by various surgeons with various techniques of open reduction and internal fixation. The patients were evaluated as per the rating of the Baird and Jackson score which included objective criteria, subjective criteria and Radiological evaluation. Results: The final outcome as per the Baird and Jackson scoring was 30.6% was Excellent, 55.6% was Good, 8.3% was Fair and 5.5% was poor. 6 patients had superficial infection and out of 6 patients 4 patients had uncontrolled diabetes. There was statistical significance between diabetes and infection (p < 0.05). Conclusion: Surgical treatment of malleolar fracture is necessary to achieve anatomical reduction of the fracture fragments. Open reduction and internal fixation within 24hours gives excellent clinical and radiological outcome following malleolar injuries.