Assessment of incidence of occurrence of fractures of posteriors malleolus region: a retrospective analysis

Background: Fracture of ankle joint involving posterior malleolus easily causes traumatic arthritis and prognosis of this fracture is poor. There are a number of controversies regarding the indications for fixation of fragments of posterior malleolus. Some studies report that if the articular surface at the distal end of the tibia accounts for more than twenty five percent, then fixation of posterior malleolus fragments should be done. In this retrospective study we evaluated the treatment effect of ankle joint fractures involving the posterior malleolus and analyzed the impact of different posterior malleolus fragment sizes on the treatment effect.Methods: A total of 52 subjects, including 23 males and 29 females, were selected for the present study. Patients with a definitive diagnosis of ankle joint fracture with involvement of the posterior malleolus and undergoing open reduction internal fixation surgery for the same were included in the present study. Mean age of the patients was 41.3 years.Results: Significant results were observed with respect to posterior malleolus fragment size and arthritis score of two groups. Non- significant results were observed with respect to difference in the American Orthopedic Foot and Ankle Society (AOFAS) score, Visual analogue scale (VAS) rating under various conditions and patient satisfaction rating.Conclusions: Treatment effect on all 52 cases of ankle joint fractures involving posterior malleolus fractures were satisfactorily.

Dilemmas in the choice of treatment of tibiofibular syndesmosis in malleolar fractures

Introduction. Ankle joint fractures are one of the most common injuries dealt with by orthopedic surgeons. Objective. To determine to what extent do diagnostics, estimation and choice of treatment of tibiofibular syndesmosis injuries affect the final clinical result. Patients and Methods. The study represents retrospective-prospective analysis of the data obtained from 102 patients treated for ankle injury due to malleolar ankle joint fractures and tibiofibular syndesmosis at the Clinic of Traumatology. The average value of monitoring was 61.62 months. According to the Danis-Weber classification, C1 fracture was present in 77 respondents (75.49%); C2 in 23 (22.5%); and C3 fracture in 2 respondents (1.96%). The Danis-Weber classification was used in this paper and hence we divided 102 patients with type C fractures according to the above mentioned classification. The first group (G1) was consisted of 48 (47%) patients who had undergone the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The second group (G2) was consisted of 54 (53%) patients who did not require the syndesmotic screw fixation during the surgery treatment of fracture stabilization. The syndesmotic screw was placed in cases of: supra-syndesmotic fractures of the fibula associated with rupture of the deltoid ligament and fracture types according to the Topliss A and B. Three, six and twelve months after the surgery, the clinical results were examined using the American Orthopaedic Foot and Ankle Society scoring scale. Discussion. All acute unstable injuries should be treated surgically, which includes the deltoid ligament repair, open reduction and internal fixation of the injured syndesmosis. This is considered to be the best way to avoid unwanted complications. Conclusion. There was no significant difference in the final results of treatment between patients from the group G1, where the syndesmotic screw fixation was performed, and patients from the group G2, where the syndesmotic screw fixation was not performed.

The Role of the Radiological Parameters in the Diagnosis of the Ankle Joint Fractures

The ankle stability and its biomechanics can be compromised after ligamentous and malleolus lesions. The complete early diagnosis, and also the early and late postsurgery results, must be formulated and explained using the tibio-astragalus radiologic indices. The paper evaluates the importance of these presurgery and postsurgery indices, analyzing also the late results under causal report. Our subordinating to the exigency of radiologic indices to obtain a reparation as anatomic as possible, shows that the surgical treatment must be applied to osteo-ligamentous lesions properly, so that to get the remake of tibio-astragalus biomechanics.