Comparison of the Results after the Surgical Treatments of the Trimalleolar Ankle Fractures

족관절 삼과 골절에 대한 치료 후 결과 비교

  • Rha, Jong-Deuk (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Park, Hyun-Soo (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Lim, Chang-Suk (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Jang, Yeung-Soo (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Park, Sang-Won (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Chung, Tae-Won (Department of Orthopaedic Surgery, Hanil General Hospital) ;
  • Jeon, Yong-Soo (Department of Orthopaedic Surgery, Hanil General Hospital)
  • 라종득 (한전의료재단 한일병원 정형외과) ;
  • 박현수 (한전의료재단 한일병원 정형외과) ;
  • 임창석 (한전의료재단 한일병원 정형외과) ;
  • 장영수 (한전의료재단 한일병원 정형외과) ;
  • 박상원 (한전의료재단 한일병원 정형외과) ;
  • 정태원 (한전의료재단 한일병원 정형외과) ;
  • 전용수 (한전의료재단 한일병원 정형외과)
  • Published : 2004.06.01

Abstract

Purpose: To evaluate the methods and results of the surgical treatment in the trimalleolar fracture of the ankle. Materials and Methods: We analysed the results of the ankle trimalleolar fracture which were treated with open reduction and internal fixation from January 1999 till September 2003. There were 45 patients who had at least six months follow up, 16 men, and 29 women. We have analysed the mechanism of injury, methods of operation and postoperative complications. Results: The results were assessed on ankle AP, lateral and mortise X-rays and retrospective chart review. There were 30 supination-external rotation, 13 pronation-external rotation, 2 pronation-abduction in the mechanism of injury by Lauge-Hansen classification. Cases of the posterior malleolar fracture which involved more than 25% of the weight bearing surface were 7 (15.6%). Medial malleolar mono-fixation was done in 5 cases, fibular mono-fixation in 2 cases, bimalleolar fixation in 32 cases, trimalleolar fixation in 6 cases. 38 cases (84.4%) were good or excellent in clincal assessment and 39 cases (86.7%) were good or excellent in radiological assessment according to the criteria of the Meyer. There was no difference of results among the surgical treatment methods. Conclusion: The results of our study indicate that the rigid fixation with early ankle motion and weight bearing is needed in ankle trimalleolar fracture. But minimal fixation is not bad in slight displaced fracture. Both anterior approach and posterior approach were useful methods to stabilization the posterior malleolar fracture. And pre-operative evaluation to detect the hidden soft tissue injuries and fracture mechanism is very important to avoid the failure.

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