Success of Posterior Malleolus Fracture Fixation with Open Reduction and Internal Fixation (ORIF) with Screw Associated with Unstable Ankle Injury

Najamuddin  Fazlani; Saeed Ali  Shah; Ashfaque Hussain  Mirjut; Shakeel Ahmed  Memon; Irfan Ali  Shaikh

doi:10.29054/apmc/2023.1301

Najamuddin Fazlani Senior Registrar, Department of Orthopedics, Bilawal Medical College LUMHS, Jamshoro Pakistan
Saeed Ali Shah Professor, Department of Orthopedics, Indus Medical College & Hospital, Tando Muhammad Khan Pakistan
Ashfaque Hussain Mirjut Consultant Orthopedic Surgeon, Liaquat University of Medical & Health Sciences, Jamshoro Pakistan
Shakeel Ahmed Memon Assistant Professor, Department of Orthopedics, Liaquat University of Medical & Health Sciences, Jamshoro Pakistan
Irfan Ali Shaikh Senior Registrar, Department of Orthopedics, Liaquat University of Medical & Health Sciences, Jamshoro Pakistan

DOI: https://doi.org/10.29054/apmc/2023.1301

Keywords: Posterior malleolus fracture, Screw, Open reduction and internal fixation, ORIF, Unstable ankle injury

Abstract

Background: Ankle fractures are among the common lower extremity injuries. Treatment for displaced fractures often involves surgery to align the surfaces of the joints, lessen tibiotalar contact stress, and prevent posttraumatic arthritis. There are currently no well-established operational criteria for surgical management of posterior malleolar fractures related to distal fibular and tibial fractures. Objective: To determine the success of posterior malleolus fracture fixation with open reduction & internal fixation (ORIF) with screw associated with unstable ankle injury. Study Design: Descriptive study. Settings: Orthopedic Unit-II, Mayo Hospital, Lahore Pakistan. Duration: From years 2015 to 2018. Methods: Patients of age 20-70 years of either gender with diagnosis of malleolus fracture with ankle fracture (on X-ray) ASA I & II presenting within 48 hours of injury were included. Patients were operated under general anesthesia. Fractures were openly reduced and fixed with screw (ORIF) and syndesmosis was reconstructed. All surgeries were1performed by a single surgical team. Patients were followed till one on monthly follow-up on 1st, 2nd, 4th and 6th month after surgery. Patients were interviewed for AOFAS score and success was labeled. Data was analyzed using SPSS 21.0. Results: The patients’ mean age was 39.17 ± 13.07 years. The study results showed that 73% patients were males whereas 27% patients were females. The mean AOFAS score at 1st Month of the patients was noted as 50.55 ± 5.23, at 6th Month of the patients was noted as 93.27 ± 4.64. Success achieved at 6th month was observed in 94(94%) patients whereas it was not observed in only 6 (6%) patients. Conclusion: The success of open reduction and internal fixation with screw for posterior malleolus fracture fixation in unstable ankle injury was observed to be high.