Outcome of Surgical management of ankle fractures: An experience of 38 cases in a tertiary care hospital.

Abstract

Objective: To determine the outcome of surgical management of ankle fractures in a tertiary care hospital. Study Design; Prospective, observational study. Place and Duration: Department of Orthopedics, Peoples University of Medical & Health Sciences Hospital Nawabshah, from January 2010 to December 2011. Patients and Methods: The study was conducted on 38 cases including 29 (76.320 male and 9 (23.68%) female, which were operated for close ankle fractures with AO principles. Fractures classified according to AO classification: Type A, Type B, Type C, the cases of the close ankle fractures were operated by open reduction and rigid internal fixation, with average follow up of 9 to 12 months. The implants used during surgery were. Malleolar screw. If3 tubular plates, 4 mm cancellous screws, 15 mm cortical screws, K. Wires and Tension band wire. Before surgery general condition of the patient was assessed. Once the patient was stable, attention was directed to ankle injury. Neurovascular status of the foot was assessed and if compromised, immediate reduction was performed. The injured extremity was placed in double U splint with ankle at 90 degree, high elevation and ice packs were applied to reduce oedema. If fracture blisters, marked haematoma or swelling was present, surgery was not performed and was postponed for a few days, with elevation and local cooling ensuring better soft tissue conditions. The stable patients were operated accordingly, and results were tabulated. Results: All cases operated for close ankle fractures with AO principles, In type A fracture 10 were male and 4 were female, in type B fracture 13 were male and 3 were female and in type C 6 were male and 2 were female with average male female ratio of 3:1. Majority 480. patients suffered due to road traffic accident, 10% during fall from height, and 21% during slip on ground or steps and 21% during sports injuries. The assessment was done for one year. 33 patients walked independently at 12-14 weeks. 5 patients had delayed weight bearing because of infection, loose metal, delayed union radiologically. Complete healing with union occur in 33 cases and malunion in 05 cases, no any case of nonunion was seen. Conclusion: In current study the results matched AO experience, Complete healing with union occur in 33 cases and inalunion in 05 cases, no any case ofnonunion was seen. Better results can be achieved if the operative technique is more precise and after treatment more dynamic.