Result of Ankle Fracture Fixation, Our Hospital Experience (original) (raw)
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Journal of Nepal Medical Association
Introduction: Ankle fractures account for about 9% of all fractures in adults. Open reduction and internal fixation is the preferred treatment for such injuries. However, surgery is not free of complications, and outcomes following surgery are not always satisfactory. Therefore, this study aimed to estimate the functional outcomes of bimalleolar ankle fractures treated by open reduction and internal fixation. Methods: This descriptive, cross-sectional study was carried out at a tertiary care center in the western region of Nepal among the patients with bimalleolar ankle fractures from March 2017 to August 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Twenty-nine cases were included in the study. Data were recorded in proforma and data analysis was done in the statistical package for social sciences (SPSS 16.0). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-handfoot score was used to assess the fina...
Assessment of operative outcome of ankle fractures: A clinical study
International Journal of Orthopaedics Sciences, 2021
Background: Ankle fractures are one of the most common fractures presenting in public hospitals. Most of the studies report the short term functional outcome post-ankle fracture surgery. Hence; the present study was undertaken for assessing operative outcome of ankle fractures. Materials and methods: A total of 40 patients operatively treated for an unstable ankle fracture were entered into a database and prospectively followed. The postoperative protocol was standardized for all patients. Complete demographic and clinical details of all the patients were obtained. Baseline characteristics, complications, additional surgery, functional status and the American Orthopaedic Foot and Ankle Society score (AOFAS) were assessed. The intervention chosen was open reduction and internal fixation of unstable ankle fractures. Functional outcome was evaluated. Results: Level of pain decreased consistently over the 3-, 6-, and 12-month follow-up periods in both study groups as measured by the AOFAS questionnaire. At 3 months, 6 months and 12 months followup, mean AOFAS score was 75.5, 80.3 and 85.3 respectively. Conclusion: Patients undergoing operative fixation of unstable ankle fractures showed reasonable functional result at the 1-year follow-up.
International Journal of Orthopaedics Sciences, 2019
To analyse the functional outcome of Ankle joint after medial malleolar fracture treated with ORIF with TBW and CC Screws. Materials and Method: This is prospective study done in Krishna medical college and hospital, karad (Satara). In this study 30 cases of Medial malleolar ankle fracture were analysed. Muller Classification used. Road traffic accident, Twisting injury and fall from height are major mode of injury. 4.0 mm Cannulated cancellous screw and TBW were used for fixation. Results: According to Baird and Jackson scoring system out of the 30 patients treated, 86.66% had excellent to good results and 13.66% had fair results. On comparing the results in both groups, better results were seen in TBW group as compared to CCS group. Conclusion: In this study we observed that the functional outcome of Ankle joint after medial malleolus fracture treated with open reduction and internal fixation with tension band wiring gives better results in range of motion and union as compared to open reduction and internal fixation with 4.0 mm cannulated cancellous screws. Thus, we conclude that open reduction and internal fixation with tension band wiring give better functional and radiological outcomes as compared to cannulated cancellous screws.
Short term outcomes of open reduction and internal fixation of unstable ankle fractures
Calcaneal fractures, often caused by a fall from a height, are the most common injuries encountered by orthopedic surgeons. Currently, open anatomic reduction and internal fixation (ORIF) is considered a valuable treatment of displaced intraarticular fractures of the calcaneus; however, the need for bone grafting in the treatment is still controversial. Therefore, in the present study, we investigated the outcomes of 2 methods (with and without bone grafting) used for the surgical treatment of Sanders type III calcaneal fractures. From January 2013 to September 2015, 57 cases (55 patients) with displaced Sanders type III calcaneal fractures (53 unilateral and 2 bilateral) were enrolled. The patients were divided into 2 groups: group I was treated by ORIF with bone grafting (n ¼ 28) and group II was treated by ORIF without bone grafting (n ¼ 29). The radiologic evaluation included B€ ohler's angle, Gissane's angle, and the height and width of the calcaneum. In addition, the American Orthopaedic Foot and Ankle Society questionnaires and visual analog scale were completed by the patients. During the follow-up period, no differences were found in the outcome measures (B€ ohler's angle, p ¼ .447; Gissane's angle, p ¼ .599; calcaneal height, p ¼ .065; calcaneal width p ¼ .077; and American Orthopaedic Foot and Ankle Society questionnaires, p ¼ .282) with or without bone grafting. The only difference between the 2 groups was the occurrence of postoperative pain (p ¼ .024 and p ¼ .05), which was greater in the patients who had undergone bone grafting. We have provided evidence that bone grafting with internal fixation in the treatment of intraarticular calcaneal fractures failed to improve the restoration of B€ ohler's angle or Gissane's angle. No statistically significant difference was found in the short-term outcomes between the 2 methods used for the surgical treatment of Sanders type III calcaneal fractures.
2016
Background: A bimalleolar ankle fracture is unique in the sense that ankle is the distal most weight bearing joint and locomotion depends upon stability of the ankle mortise. The best option for management of bimalleolar ankle fracture still remains unclear because of the variability of fracture patterns and availability of variety of implants. Objectives: This study was conducted to set the indications for the two modalities of surgical fixation viz-fibular plate fixation and fibula nailing in various fracture subtypes; and to compare the functional outcome of bimalleolar ankle fracture managed by these two methods at 9 months post-operative interval. Complications associated with specific modalities of fixation were also studied. Material and Method: This was a randomized, prospective and comparative study for the methods used for management of the fracture done in Department Of Orthopedics and Traumatalogy at USSC, Indore from January 2014 to April 2016. 45 patients with bimalleolar fractures were included in the study. Clearance from ethical committee of the institute was taken. Informed consent was taken and patients were evaluated pre operatively and post operatively at 1, 3, 6 and 9 months interval with the help of Olerud Molander Ankle Score (OMAS) and radiographically. Results: Duration after which partial weight bearing was initiated was significantly shorter in group1 (fibula plating) (p<0.0001) [average 44.54 days as compared to 55.71 days]. The average time before union and hence full weight bearing was 11.89 weeks (range10.71-13.28 weeks) in group 1 and 13.67 weeks (range11.56-15 weeks), (p<0.0001) in group 2 (Intramedullary nailing). Functional outcome using OMAS scoring at 3 months post operatively was significantly better in group 1(p< 0.0001). While at 6 months and 9 months post operatively the functional outcomes were similar. Conclusion: We concluded that Fibula Plating is a better method of fixation in AO type B2, B3 and C2 fractures while Intramedullary Nailing in Fibula is a better method of fixation in AO type A2 fractures with respect to clinical and functional outcomes. We also concluded that if the ligament injury has been dealt with properly and repaired and the fixation is anatomically sound the period of immobilization (4 to 6 weeks) does not affect the range of motion of ankle joint in the long duration.
IOSR Journals , 2019
Background: Malleolar injuries are the most common significant lower extremity fractures. These injuries gain importance, because the whole body weight is transmitted through the ankle, and locomotion depends on the stability of the ankle. Open reduction and internal fixation have become the mainstay of treatment for most of the unstable bimalleolar fractures, as these operative methods restores the anatomy, biomechanics and contact loading characteristics of the ankle. Objectives: 1. To study the functional outcome of surgically managed bimalleolar fractures of ankle in adults. 2. To restore the anatomy of malleoli and ankle perfectly by operative treatment with internal fixation Methods: A prospective study of 30 cases of bimalleolar fractures of ankle in adults, managed surgically by screw for medial malleolus and plate for lateral malleolus during the period from dec 2015- June 2017 and followed up to dec 2017,at Narayana medical college ,Nellore. Inclusion Criteria: • All closed fractures. • Open type 1, 2 , 3a ( Gustillo-Anderson). • Above 18 years. Exclusion Criteria: • With associated Pilon fracture. • Patients unfit for surgery. • Patients with minimally displaced mono-malleolar fractures, avulsion fractures and stable fractures Follow-up was taken at 1month, 3 months, and 6 months post-operatively. At every visit check radiographs were taken to assess the radiological union. Results: In our study we achieved 86.6% excellent to good results, 6.6% fair results, 6.6% poor results. The results were comparable to other studies. Conclusions - The operative results were satisfactory in 86.6% cases, with good to excellent functional outcome. • Excellent results are obtained with stable fixation of fracture. Cancellous screws or malleolar screws are better in internal fixation of medial malleolus and lateral plating was the best for fibular fractures. • Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing and mobilisation is achieved in these patients. • Anatomical reduction with restoration of the articular congruence is essential in all intra articular fractures, more so, if a weight bearing joint like ankle is involved. Open reduction and internal fixation restores the articular congruity of the ankle joint.
Ankle Fractures: The Operative Outcome
Malaysian Orthopaedic Journal, 2011
Ankle fractures are commonly seen in orthopaedic practice. This retrospective study of patients with ankle fractures who underwent surgical treatment in our institution from January 2000 to December 2003 was undertaken to analyze the common causes and patterns of ankle fractures; and the functional outcome of operative treatment for these fractures. Eighty patients were identified and reviewed. There were 65 male (81.3%) and 15 female patients (18.7%) with age ranging from 13 to 71 years old (mean, 32.3y). Common causes of ankle fractures were trauma (especially motor vehicle accidents), sports injuries and the osteoporotic bones in the elderly. Weber C (64.0%) was the most common pattern of fracture at presentation. The most common operative treatment for ankle fractures was open reduction and internal fixation (73 patients, 91.2%). Excellent and good outcomes were achieved in 93.8% of cases when measured using the Olerud and Molander scoring system for foot and ankle. In conclusion, operative treatment for ankle fractures restores sufficient stability and allowed mobility of the ankle joint.
Unsatisfactory outcome following surgical intervention of ankle fractures
Foot and Ankle Surgery
The aim of this study was to evaluate outcome after surgical intervention in patients with ankle fractures. Fifty-four patients consecutively operated were included. A standardised protocol was used to record a number of variables regarding patient characteristics, type of fracture and treatment. Radiographic examination was performed in all patients postoperatively and after 14 months. A questionnaire containing the Olerud–Molander Ankle Score (OMAS) and some supplementary questions was used 14 months and 3 years after surgery. The median OMAS was 75 at the 14-month and 85 at the 3-year follow-up. Patients !40 years of age scored significantly better. Only 50% returned to the same activity level 14 months after injury. Pain, stiffness and swelling were present among more than half of the patients and 40% reported instability and problems when using stairs. In conclusion, subjective outcome 3 years after surgical intervention for ankle fractures is poorer than expected.