The Radiographic and Functional Outcome of Bimalleolar Fractures Treated by Open Reduction and Internal Fixation with Screws/Tbw and Plates: A Prospective Study Volume 5 - Issue 1

Dharmesh Patel*, Avtar Singh, Rajeev Vohra and Sandeep Chauhan

• Senior Resident, MBBS, DNB (Ortho), University Amandeep Hospital, India

Received:February 05, 2021;   Published:February 23, 2021

Corresponding author: Dharmesh Patel, Senior Resident, MBBS, DNB (Ortho), University Amandeep Hospital, G T road, Model Town, Amritsar, Punjab, India

DOI: 10.32474/OSMOAJ.2021.05.000204

 

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Abstract

Background: Bimalleolar fractures are one of the most common fractures in orthopedic traumatology. As with all intra articular fracture, malleolar fracture necessitate accurate reduction and stable internal fixation. When malleolar fractures are not reduced accurately they may lead to post traumatic painful restriction of motion or osteoarthritis or both. To study the functional and radiological outcome and result of surgical treatment of bimalleolar fractures and to know the complication of open reduction internal fixation in bimalleolar fractures.

Materials and Methods: A Prospective review was conducted for 60 patients between January 2018 to December 2019 with closed bimalleolar fracture. Open reduction and internal fixation was done with specific modalities. Patients were evaluated with Subjective and objective assessments of the patients’ ankles were done using a modification of the scoring system proposed by Olerud and Molander and radiologically by Kristenson criteria. The functional and radiographic outcome of ORIF and advantages of the procedures were recorded. Functional and radiographic evaluations were performed at immediate post op, 6 weeks, 3 months and 6 months, 1 year after surgery. At each follow up, patients were assessed for syndesmotic reduction, loss of fixation, and implant failure and any arthritis changes. The reduction in quality was evaluated on immediate postoperative radiography.

Results: In the present study of 60 patients with bimalleolar fractures treated by open reduction and internal fixation. Excellent results were achieved in 49 (81.7%) patients, good in 9 (15%), and poor in 2 (3.3%) patient. The patient with poor result had mild pain with activities of daily living, diminution in the abilities to run and to do work, reduced motion of ankle and narrowing of joint space.

Conclusions: Understanding the mechanism of injury is essential for good reduction and internal fixation. The fibular length has to be maintained for lateral stability of the ankle. Anatomical reduction is essential in all intra articular fractures more so if a weight bearing joint like ankle joint is involved. Our series encourage operative intervention within 48 hours in the management of bimalleolar fractures of the ankle as the key for high percentage of good result.

Keywords: Bimalleolar Fracture; Plating; Tension Band Wiring; Olerud And Molander Ankle Score; Open Reduction and Internal Fixation

Abstract| Introduction| Aims and Objectives| Materials And Methods| Results| Discussion| Conclusion| References|