Journal List > J Korean Orthop Assoc > v.27(7) > 1114429

Kim, Byun, and Park: The Treatment and Clinical Analysis of Lateral Malleolar Fracture of the ankle with One or Two Cortical Lag Screws

Abstract

The ankle joint is a modified hinge joint which plays an important role in weight bearing, walking and standing. Due to this reason, inadequately treated ankle joint injury results in a severe restriction of joint motion and unhappy complication such as posttraumatic arthritis. So complete repair of injuired ligamentous structures aroung the ankle joint and rigid fixation of fractured malleoli are very important. Recently, the importance of accurate reduction and rigid fixation of the fracture at lateral malleolus has been emphasized than any other fracture of the ankle. Because the fracture patterns of lateral malleolus are short oblique, spiral or long oblique in most cases, it could be possible to obtain rigid and firm anatomical fixation with one or two 3.5mm cortical screws by using interfragmentary lag screwing principle. Anthors have been used only one or two 3.5mm cortical screws for the rigid anatomical fixation of the fractured lateral malleoli in 38 patients (38 cases)from May 1989 till December 1990 and analysed their results through average 13 months follow up. The results obtained were as follows; 1. Among the 38 cases, male was 31 cases (82%), female was 7 cases (18%) and the average age of the patients was 31.9 years. 2. The most common cause of injury was traffic accident (16 cases, 42%) and others were slipping down (14 cases, 37%) and sports injury (8 cases, 21%) in orders. 3. The most common type of fracture was type C (20 cases, 52.6%) and next was type B (10 cases, 26.3%) and type A (8 cases, 21%) according to the classification of DanisWeber. 4. In the fracture of Weber type C, distal tibiofibular ligaments were ruptured in 18 cases (90%) and all ruptured ligaments were repaired directly or anchored at their original sites through the drill holes when direct repair was impossible. 5. In the 3 cases, transfixation was done by using 3 cortex elastic fixation method with one 3.5mm cortical screw. 6. Bony union was obtained within 3 months in all cases without complication such as nonunion or delayed union. 7. The result was excellent in 35 cases (92%), good in 3 cases (8%) and poor result was absent according to the criteria of Meyer et al. In conclusion, most lateral malleolar fracture can be treated successfully by the rigid anatomical fixation with only one or two cortical lag screws.

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