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Journal of Orthopedic Education

Volume  5, Issue 2, May-August 2019, Pages 97-102
 

Original Article

Surgical Management of Bimalleolar Fractures By Open Reduction Internal Fixation

K. Rajender1, Ashwin Kasturi2, Chokkarapu Ramu3, Pavan Kumar Avadanam4, Venu Gesukonda5, K Vamsidhar Reddy6

1,5,6Associate professor, 3,4Professor, Department of Orthopedic, Chalmeda Anand Rao Institute of Medical Sciences, Bommakal Village, Karimnagar, Telangana 505001, India. 2Professor, Department of Orthopedic, RVM Institute of Medical Sciences and Research Center, Siddipet, Telangana 502279, India.

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DOI: DOI: http://dx.doi.org/10.21088/joe.2454.7956.5219.4

Abstract

Introduction: Ankle joint is highly congruous and any disturbance of the normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. Malleolar fractures are one of the most common fractures in orthopaedic traumatology. As with all intra articular fractures, malleolar fractures necessitate accurate reduction and stable internal fixation. This study was therefore performed to study the functional outcome and results of surgical treatment of bimalleolar fractures and to know the complications of open reduction internal fixation of bimalleolar fractures. Materials and methods: 30 patients who came to the emergency ward in our hospital with fresh bimalleolar fractures were included into the study. The lower end of tibia fibula including both malleoli, calcaneus and talus were examined and looked for local bony tenderness and bony irregularities, displacement, on natural mobility crepitus, inter relation of malleoli, springing of fibula, dorsalis pedis and posterior tibial artery pulsations were checked and noted. After the surgery, the patients were followed up until the union was complete. Results: The mean age of our study was 40 years with 73% of the patients being male. The most common mode cause of injury was road traffic accidents affecting 15 (50%) of the people, while slipping was the cause in 13 cases. The most common type of injury was Supination external rotation affecting 40% of the patients, followed by pronation abduction in 20% of the patients. 16.7% of the patients were affected by pronation external rotation and 113.3% of them had supination adduction. In the present study, 13 (43.3%) had no pain and 14 (46.7%) patients had grade B i.e. pain with strenuous activities and remaining 3 (10%) had pain with activities of daily living. In the present study of 30 patients with bimalleolar ankle fractures treated by open reduction and internal fixation. Excellent results were achieved in 13 (43%), good in 10 (33%), fair in 6 (20%) and poor in 1 (3%) of patients. The patients with poor result had mild pain with activities of daily living, diminution in the abilities to run/work, reduced ankle movements and decreased joint space. Conclusion: Open reduction and internal fixation in accordance with AO principles was an efficient way to manage Bimalleolar Ankle Fractures.

Keywords: Bimalleolar Ankle Fractures; Open reduction; Internal fixation


Corresponding Author : Dr. Ashwin Kasturi