Chapter-38 Malleolar Fracture

2013 ◽  
pp. 469-484
Author(s):  
Vivek Trikha
Keyword(s):  
Malleolar Fracture

Single Hemicerclage for Lateral Type B Malleolar Fracture - A Novel, Minimal and Reliable Osteosynthesis

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 283-288
Author(s):  
Maurer ◽  
Stamenic ◽  
Stouthandel ◽  
Ackermann ◽  
Gonzenbach
Keyword(s):  
Ankle Joint ◽  
Weight Bearing ◽  
Fracture Type ◽  
Type B ◽  
Malleolar Fracture ◽  
Metallic Wire ◽  
Long Term Outcome ◽  
X Ray ◽  
Upper Ankle Joint ◽  
Upper Ankle

Aim of study: To investigate the short- and long-term outcome of patients with isolated lateral malleolar fracture type B treated with a single hemicerclage out of metallic wire or PDS cord. Methods: Over an 8-year period 97 patients were treated with a single hemicerclage for lateral malleolar fracture type B and 89 were amenable to a follow-up after mean 39 months, including interview, clinical examination and X-ray controls. Results: The median operation time was 35 minutes (range 15-85 min). X-ray controls within the first two postoperative days revealed an anatomical restoration of the upper ankle joint in all but one patient. The complication rate was 8%: hematoma (2 patients), wound infection (2), Sudeck's dystrophy (2) and deep vein thrombosis (1). Full weight-bearing was tolerated at median 6.0 weeks (range 2-26 weeks). No secondary displacement, delayed union or consecutive arthrosis of the upper ankle joint was observed. All but one patient had restored symmetric joint mobility. Ninety-seven percent of patients were satisfied or very satisfied with the outcome. Following bone healing, hemicerclage removal was necessary in 19% of osteosyntheses with metallic wire and in none with PDS cord. Conclusion: The single hemicerclage is a novel, simple and reliable osteosynthesis technique for isolated lateral type B malleolar fractures and may be considered as an alternative to the osteosynthesis procedures currently in use.

scholarly journals Treating AO/OTA 44B lateral malleolar fracture in patients over 50 years of age: periarticular locking plate versus non-locking plate

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Chien-An Shih ◽  
I-Ming Jou ◽  
Pei-Yuan Lee ◽  
Chin-Li Lu ◽  
Wei-Ren Su ◽  
...  
Keyword(s):  
Locking Plate ◽  
Plate Versus ◽  
Malleolar Fracture

scholarly journals Percutaneous posteroanterior screw fixation for Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture: Operative technique and randomized clinical results

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199799
Author(s):  
Tianming Yu ◽  
Jichong Ying ◽  
Jianlei Liu ◽  
Dichao Huang ◽  
Hailin Yan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Malleolar Fracture ◽  
Malleolar Fractures ◽  
Posterior Malleolar Fracture ◽  
Post Traumatic ◽  
Group 2 ◽  
Traumatic Arthritis ◽  
Group 1

Purpose: The study described a novel surgical treatment of Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture and patient outcomes at intermediate period follow-up. Methods: All patients from January 2015 to December 2017 with tri-malleolar fracture of which posterior malleolar fractures were Haraguchi type 1, were surgically treated in this prospective study. Lateral and medial malleolar fractures were managed by open reduction and internal fixation through dual incision approaches. 36 cases of Haraguchi type 1 posterior malleolar fractures were randomly performed by percutaneous posteroanterior screw fixation with the aid of medial exposure (group 1). And 40 cases were performed by percutaneous anteroposterior screw fixation (group 2). Clinical outcomes, radiographic outcomes and patient-reported outcomes were recorded. Results: Seventy-six patients with mean follow-up of 30 months were included. There were no significant differences in the mean operation time (81.0 ± 11.3 vs. 77.2 ± 12.4), ankle function at different periods of follow-up, range of motions and visual analog scale (VAS) at 24 months between the two groups ( p > 0.05). However, the rate of severe post-traumatic arthritis (Grade 2 and 3) and the rate of step-off rather than gap in radiological evaluation were lower in group 1 than that in group 2 ( p < 0.05). Conclusion: Using our surgical technique, more patients had good outcome with a lower rate of severe post-traumatic arthritis, compared with the group of percutaneous anteroposterior screw fixation. Percutaneous posteroanterior screw fixation can be a convenient and reliable alternative in treating Haraguchi type 1 posterior malleolar fracture.

scholarly journals Open ankle dislocation without associated malleolar fracture: Review of the literature

2017 ◽  
Vol 8 ◽  
pp. 20-23
Author(s):  
Hassan Elsayed ◽  
Ramesh Thalava ◽  
Hytham Afifi ◽  
Mohammad Khan
Keyword(s):  
Review Of The Literature ◽  
Malleolar Fracture ◽  
Ankle Dislocation

Arthroscopic Treatment of Isolated Anterior Malleolar Fracture of the Ankle

1999 ◽  
Vol 12 (2) ◽  
pp. 477
Author(s):  
Dong Wha Lee ◽  
Kyoo Seog Shin ◽  
Jong Soon Kim ◽  
Yong Whee Kim
Keyword(s):  
Arthroscopic Treatment ◽  
Malleolar Fracture

Usefulness of Computed Tomography in Patients with Acute Malleolar Fracture

2015 ◽  
Vol 19 (4) ◽  
pp. 156
Author(s):  
Suk-Ha Jeon ◽  
Su-Young Bae ◽  
Soo-Hyung Ahn ◽  
Hyung-Jin Chung ◽  
Seung-Hun Woo
Keyword(s):  
Computed Tomography ◽  
Malleolar Fracture

Unrecognized Anterior Compartment Syndrome Following Ankle Fracture Surgery

2009 ◽  
Vol 99 (5) ◽  
pp. 438-442 ◽  
Author(s):  
Aksel Seyahi ◽  
Serkan Uludag ◽  
Senol Akman ◽  
Mehmet Demirhan
Keyword(s):  
Compartment Syndrome ◽  
Ankle Fracture ◽  
Open Reduction ◽  
Malleolar Fracture ◽  
Anterior Compartment ◽  
Exercise Induced ◽  
Patient’S History ◽  
Fracture Surgery ◽  
Compartmental Pressure ◽  
Suspected Diagnosis

A 35-year-old male sustained a lateral malleolar fracture while playing football. The fracture was treated by open reduction and internal fixation with a tourniquet. The next day, the patient returned with pain and swelling of the ankle and was admitted again to the hospital with a suspected diagnosis of cellulitis. Ten hours later, the patient developed the symptoms of anterior compartment syndrome. Emergency open fasciotomy of the anterior compartment was performed. The retrospective analysis of the patient’s history was suggestive of a predisposition to an exercise-induced compartment syndrome. We think that exertional increase of the compartmental pressure before the injury and the tourniquet used during surgery contributed together to the development of compartment syndrome. Physicians should be vigilant in identifying the features of compartment syndrome when managing patients injured during a sporting activity. (J Am Podiatr Med Assoc 99(5): 438–442, 2009)

Prospective Evaluation of the Ottawa Ankle Rules in a University Sports Medicine Center

1998 ◽  
Vol 26 (2) ◽  
pp. 158-165 ◽  
Author(s):  
John J. Leddy ◽  
Robert J. Smolinski ◽  
James Lawrence ◽  
Jody L. Snyder ◽  
Roger L. Priore
Keyword(s):  
Sports Medicine ◽  
Ankle Injuries ◽  
Fracture Rate ◽  
Malleolar Fracture ◽  
Potential Reduction ◽  
Malleolar Fractures ◽  
Ottawa Ankle Rules ◽  
Clinically Significant ◽  
Sensitivity Specificity ◽  
Fracture Identification

In a sports medicine center, we prospectively evaluated the Ottawa Ankle Rules over 1 year for their ability to identify clinically significant ankle and midfoot fractures and to reduce the need for radiography. We also developed a modification to improve specificity for malleolar fracture identification. Patients with acute ankle injuries ( 10 days old) had the rules applied and then had radiographs taken. Sensitivity, specificity, and the potential reduction in the use of radiography were calculated for the Ottawa Ankle Rules in 132 patients and for the new “Buffalo” rule in 78 of these patients. There were 11 clinically significant fractures (fracture rate, 8.3% per year). In these 132 patients, the Ottawa Ankle Rules would have reduced the need for radiography by 34%, without any fractures being missed (sensitivity 100%, specificity 37%). In 78 patients, the specificity for malleolar fracture for the new rule was significantly greater than that of the Ottawa Ankle Rules malleolar rule (59% versus 42%), sensitivity remained 100%, and the potential reduction in the need for radiography (54%) was significantly greater. The Ottawa Ankle Rules could significantly reduce the need for radiography in patients with acute ankle and midfoot injuries in this setting without missing clinically significant fractures. The Buffalo modification could improve specificity for malleolar fractures without sacrificing sensitivity and could significantly reduce the need for radiography.

PROPER SCREW LENGTH FOR FIXATION OF THE MEDIAL MALLEOLAR FRACTURE OF ANKLE

2000 ◽  
Vol 13 (3) ◽  
pp. 522
Author(s):  
Dong Bae Shin ◽  
Soo Hong Han ◽  
Seung Soo Jeon
Keyword(s):  
Malleolar Fracture ◽  
Screw Length

scholarly journals Open anterolateral fracture dislocation of ankle joint: a rare case report

2018 ◽  
Vol 5 (1) ◽  
pp. 192
Author(s):  
Prasanna Anaberu ◽  
R. Prathik ◽  
R. Manish
Keyword(s):  
Ankle Joint ◽  
Fracture Fixation ◽  
Road Traffic ◽  
Emergency Operation ◽  
High Energy ◽  
Fracture Dislocation ◽  
Anterior Dislocation ◽  
Malleolar Fracture ◽  
Rare Injury ◽  
Wound Debridement

<p class="abstract">Anterior ankle dislocation with associated compound bi-malleolar fracture is a rare injury. Ankle fracture dislocations most frequently occurs in young males caused by high energy trauma. The direction of the joint dislocation is determined by the position of the foot and the direction of the force being applied. A middle aged male presented to us with history of road traffic accident and was diagnosed to have anterior dislocation of right ankle joint with compound bi-malleolar fracture. Patient was taken to emergency operation theatre for wound debridement and immediate ankle reduction done under sedation. Due to wound contamination fracture fixation was delayed, once the wound healed bi-malleolar fracture fixation was done.</p>

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