Comparative Study between Fixation of Small Size Posterior Malleolus and Conservative Treatment
G.A.Hosny, E.M.Bayomy, M.Abouzied and A.A.Abdallah"
Ankle fractures are among the most common lower extremity injuries. Displaced fractures typically are treated operatively to restore anatomic alignment of joint surfaces, reduce tibiotalar contact stresses, and minimize posttraumatic arthritis. Treatment of these fractures must include intraoperative examination of the syndesmosis to ensure its integrity. determine result of fixation of small fragement posterior malleolus versus conservative treatment on syndesmotic stability. This study was conducted on twenty patients who were candidate for operative treatment of pottâ€Ÿs fracture with posterior malleolus fracture at Benha university hospitals. Patients were divided into two groups; Group I: Underwent posterior malleolus fixation with or without syndesmotic screw. Group II: Underwent conservative treatment with Syndesmotic screw. Mean age of the study population was 39 years, The most frequent side was right side (60.0%) while left side was 40.0%. The most frequent mechanism of injury was SER (60.0%) followed by PER (40.0%). As regard skin condition, 70.0% of patients showed skin edema. As regard integrity of skin, 90.0% of patients showed closed fracture, 10.0% showed open fracture grade I. There was no significant difference between both groups as regard AOFAS. P value was 0.517. There was no significant difference between both groups as regard ROM. P value was 0.517. There was no significant difference between both groups as regard union time. P value was 0.853.
Great benfit of fixation of posterior malleolus on sydesmotic stability as syndesmotic stability restore without need supplemental fixation of syndesmosis provided that AITFL and PITFL are intact. If AITFL, PITFL torn fixation of posterior malleolus alone not suffient supplemental fixation of syndesmosis is required in addition to reduction and fixation of posterior malleolus.
Fixation, Posterior malleolus, Conservative treatment.