The Functional Outcome of Bimalleolar Fractures Treated by Open Reduction and Internal Fixation with Screws and Plates

Abstract

Background and Objective: Bimalleolar fractures are one of the most common fractures in orthopaedic traumatology. As with all intra articular fracture, malleolar fracture necessitate accurate reduction and stable internal fixation. When malleolar fractures are not reduced accurately they may lead to post traumatic painful restriction of motion or osteoarthritis or both. To study the functional outcome and result of surgical treatment of bimalleolar fractures and to know the complication of open reduction internal fixation in bimalleolar fractures. Materials and Methods: A prospective study of thirty patients of age group of 18-60 years of acute bimalleollar fractures irrespective of gender, done at medical college and research centre. Fractures were classified on basis of danis-weber classification system. They were treated with open reduction and internal fixation with canulatedcancellous screws for medial malleoli and plates for lateral malleoli. Post operatively sequential radiographs at 0, 2 and 6 months are taken and functional evaluation is done by olerud and molander ankle score. Result: Olerudmolander ankle score was used to assess the functional outcome of the fracture fixation at 2, 3 and 6 months of follow up. At 2 months majority of patients were showing poor result at 3 months majority of patients showing fair result. And at 6 months majority of patients were showing excellent and good result. Conclusion: Understanding the mechanism of injury is essential for good reduction and internal fixation. The fibular length has to be maintained for lateral stability of the ankle. Anatomical reduction is essential in all intra articular fractures more so if a weight bearing joint like ankle joint is involved.