Amit Saraf1, Manish Singhal2, Najmul Huda3
BACKGROUND
Ankle fractures are among the most common injuries encountered by orthopaedic
surgeons. An ankle is considered unstable when the loss of normal constraints
around the ankle permits the talus to move in a non-physiologic pattern. Under
such circumstances, the dynamic joint surface contact area within the ankle is
diminished, which predisposes to articular cartilage damage and premature
degeneration. In today’s time, many modalities are available for surgical fixation
of bimalleolar fractures. Such interventions restore anatomy and biomechanics of
the ankle joint. Even though there are plethora of foreign studies on similar matter,
deficiency of such analysis has been depicted in literature from developing
countries, particularly from South-East Asian region. In this study, we wanted to
assess various methods of internal fixation in ankle fracture & evaluate their clinical
and radiological outcome post-operatively.
METHODS
26 ankle fracture patients in the age group of 18 - 60 years were included in this
study. Fractures were classified pre-operatively based on Lauge-Hansen
classification. Patients were followed up at regular intervals of 1st, 2nd, 3rd, 6th &
12 month after surgery and assessed by Baird and Jackson scoring system based
on subjective, objective and radiographic criteria. Complications like infection,
arthritis, stiffness & implant failure were assessed on regular follow-up.
RESULTS
Variety of methods (including k-wires, plates & screws) were used for surgical
fixation. Majority of fractures resulted from road traffic accident (RTA). Patients
were evaluated using Baird & Jackson scoring system during follow-up at 1st, 2nd,
3rd, 6th & 12 month. All patients had poor scores for initial 3 months. Patients
showed good to excellent result on final follow-up at 9 to 12 months after surgery.
Complications were observed in 19 % cases with arthritis being most common.
CONCLUSIONS
Open reduction and internal fixation restores the articular congruity of the ankle
joint. The operative result was satisfactory with good clinical outcome.
