ISSN: 1859 - 2872
Evaluation of internal fixation surgery outcomes for closed trimalleolar fractures at 108 Military Central Hospital
Main Article Content
Keywords
Abstract
Objective: To evaluate the outcomes of internal fixation surgery on patients with closed trimalleolar fractures at Military Central Hospital 108. Subject and method: A retrospective descriptive study was conducted on 34 patients diagnosed with closed trimalleolar fractures who underwent internal fixation from January 2015 to September 2025. Injury characteristics, treatment methods, and functional outcomes (AOFAS), and bone union results were studied and evaluated. Result: 32/34 patients underwent surgery using the posterolateral approach. The posterior malleolus was treated with open reduction and direct fixation. The main fixation devices for the posterior malleolus (MCS) were cancellous screws (52.9%) or plates and screws (44.1%). The medial malleolus was fixed using cancellous screws in 24/34 patients, or a combination of cancellous screws and Kirschner wires in 8/34 patients, and tension band wiring (figure-of-eight) in 2/34 patients. The fibula was fixed using plates and screws in all 34/34 patients. Complete anatomical restoration was achieved post-surgery in all 34/34 patients. Long-term results showed the mean AOFAS score was 91.12 ± 9.2, and the overall good/fair outcome rate was 97.1%. Conclusion: Internal fixation surgery is an effective treatment method for closed trimalleolar fractures, ensuring anatomical restoration and ankle joint function.
Article Details
References
2. Neumann AP, Rammelt S (2022) Ankle fractures involving the posterior malleolus: patient characteristics and 7-year results in 100 cases. Arch Orthop Trauma Surg 142(8): 1823-1834.
3. Bartoníček J, Rammelt S, Tuček M (2017) Posterior Malleolar Fractures: Changing Concepts and Recent Developments. Foot Ankle Clin 22(1): 125-145.
4. Bartoníček J, Rammelt S, Tuček M và Naňka O (2015) Posterior malleolar fractures of the ankle. Eur J Trauma Emerg Surg 41(6): 587-600.
5. Xu HL, Li X, Zhang DY et al (2012) A retrospective study of posterior malleolus fractures. Int Orthop, 36(9): 1929-1936.
6. Drijfhout van Hooff CC, Verhage SM, Hoogendoorn JM (2015) Influence of fragment size and postoperative joint congruency on long-term outcome of posterior malleolar fractures. Foot Ankle Int 36(6): 673-678.
7. Hoogendoorn JM (2017) Posterior Malleolar Open Reduction and Internal Fixation Through a Posterolateral Approach for Trimalleolar Fractures. JBJS Essent Surg Tech 7(4): 31.
8. Đinh Xuân Chương (2024) Đánh giá kết quả phẫu thuật kết hợp xương (KHX) điều trị gãy kín ba mắt cá chân tại Bệnh viện Hữu nghị Việt Đức. Tạp chí Y học Việt Nam.
9. Kitaoka HB, Alexander IJ, Adelaar RS et al (1994). Clinical rating systems for the ankle-hindfoot, midfoot, hallux, and lesser toes. Foot Ankle Int, 15(7): 349-353.
10. Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis, 16(4): 494-502.
11. Choi JY, Kim JH, Ko HT và Suh JS (2015) Single Oblique Posterolateral Approach for Open Reduction and Internal Fixation of Posterior Malleolar Fractures With an Associated Lateral Malleolar Fracture. J Foot Ankle Surg 54(4): 559-564.
12. Tosun B, Selek O, Gok U và Ceylan H (2018) Posterior Malleolus Fractures in Trimalleolar Ankle Fractures: Malleolus versus Transyndesmal Fixation. Indian J Orthop 52(3): 309-314.
13. Erdem MN, Erken HY, Burc H et al (2014). Comparison of lag screw versus buttress plate fixation of posterior malleolar fractures. Foot Ankle Int 35(10): 1022-1030.
14. OʼConnor TJ, Mueller B, Ly TV et al (2015) "A to p" screw versus posterolateral plate for posterior malleolus fixation in trimalleolar ankle fractures. J Orthop Trauma 29(4): 151-156.
15. Huang RK, Xie M, Zhao JJ et al (2012) Posterior malleolar fracture: technique and clinical experience of the posterolateral approach. Chin J Traumatol, 15(1): 23-26.
16. Li YD, Liu SM, Jia JS, Zhou JL (2011) [Choice of internal fixation methods for posterior malleolus fracture in both biomechanics and clinical application]. Beijing Da Xue Xue Bao Yi Xue Ban, 43(5): 718-23.
17. Anwar A, Zhang Z, Lv D et al (2018) Biomechanical efficacy of AP, PA lag screws and posterior plating for fixation of posterior malleolar fractures: A three dimensional finite element study. BMC Musculoskelet Disord 19(1): 73.
18. Nguyễn Ngọc Thành (2021) Đánh giá kết quả điều trị gãy kín mắt cá sau bằng nẹp vít. Đại học Y Dược Thành phố Hồ Chí Minh.
19. Choi JY, Kim JH, Ko HT, Suh JS (2015) Single Oblique Posterolateral Approach for Open Reduction and Internal Fixation of Posterior Malleolar Fractures With an Associated Lateral Malleolar Fracture. J Foot Ankle Surg 54(4): 559-564.
Article Sidebar
