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Category: Volume 06 Issue 06 June 2018
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Title: Posterior Malleolar Fracture Fixation in Semilateral Position: A Review Study of 15 Cases

Authors: Dr Amit Lakhani, Dr Karan Alwadhi, Dr S M Bhatnagar

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.183

Abstract

Objective: Ankle fracture is a common orthopedic injury1. Ankle laxity varies depending on the plantar flexion-dorsiflexion position and the direction of the applied force so light rotational forces can cause complex ankle fracture2. Careful evaluation of x rays and clinical examination are mandatory for succeful outcome.

Methods: We reviewed 15 cases of ankle fracture with posterior malleolar involvement. We operated all cases by posterolateral approach in semi lateral position.

Result: Semilateral position and posterolateral approach allows a great exposure of all malleoli. This makes interpretation of fracture and fixation easy.

Conclusion: we strongly recommend semilateral position and posterolateral approach for all fibula fracture with post. malleoli involvement.

Keywords:  posterior malleoli, planter flexion, dorsiflexion, pasterolateral, semilateral.

References

  1. Foot Ankle Int. 2005 Aug;26(8):633-7., Arch Osteoporos. 2017 Aug 28;12(1):75. doi: 10.1007/s11657-017-0369-5., Lower limb fracture presentations at a regional hospital.. Holloway KL1, Yousif D2, Bucki-Smith G2, Hosking S2,3, Betson AG2, Williams LJ2, Brennan-Olsen SL2,3,4,5, Kotowicz MA2,5,6, Sepetavc A2, Pasco JA2,5,6.
  2. Analysis of ankle-hindfoot stability in multiple planes: an in vitro study. Fujii T1, Kitaoka HB, Luo ZP, Kura H, An KN.
  3. J Foot Ankle Surg. 2015 Mar-Apr;54(2): 203-6. doi: 10.1053/j.jfas.2014.10.015. Epub 2014 Dec 5., Are low-energy open ankle fractures in the elderly the new geriatric hip fracture?, Toole WP1, Elliott M2, Hankins D2, Rosenbaum C2, Harris A2, Perkins C2.
  4. J Orthop Trauma. 1992;6(1):96-101. Posterior malleolar ankle fractures: an in vitro biomechanical analysis of stability in the loaded and unloaded states., Scheidt KB1, Stiehl JB, Skrade DA, Barnhardt T.
  5. J Orthop Trauma. 2015 Apr;29(4):e151-6. doi: 10.1097/BOT.0000000000000230."A to p" screw versus posterolateral plate for posterior malleolus fixation in trimalleolar ankle fractures. OʼConnor TJ1, Mueller B, Ly TV, Jacobson AR, Nelson ER, Cole PA.
  6. 1999 Jun;28(6):460-8. [The upper ankle joint. Biomechanics and functional anatomy].[Article in German], Seiler H1.
  7. Bone Joint J. 2016 Jun;98-B(6):812-7. doi: 10.1302/0301-620X.98B6.36497. Open reduction and internal fixation of posterior malleolar fractures using the posterolateral approach. Verhage SM1, Boot F1, Schipper IB2, Hoogendoorn JM2.
  8. Eur J Trauma Emerg Surg. 2015 Dec;41(6):587-600. doi: 10.1007/s00068-015-0560-6. Epub 2015 Aug 8. Posterior malleolar fractures of the ankle. Bartoníček J1,2, Rammelt S3, Tuček M4, Naňka O5.
  9. Can J Surg. 2005 Dec;48(6):487-90. Posterolateral approach for open reduction and internal fixation of trimalleolar ankle fractures. Talbot M1, Steenblock TR, Cole PA.
  10. Foot Ankle Clin. 2017 Mar;22(1):125-145. doi: 10.1016/j.fcl.2016.09.009. Epub 2016 Dec 20. Posterior Malleolar Fractures: Changing Concepts and Recent Developments. Bartoníček J1, Rammelt S2, Tuček M3.
  11. J Bone Joint Surg Am. 1988 Oct;70(9):1348-56. Posterior malleolar fractures of the ankle associated with external rotation-abduction injuries. Results with and without internal fixation. Harper MC1, Hardin G.
  12. Foot Ankle Int. 2015 Apr;36(4):377-82. doi: 10.1177/1071100714558845. Epub 2014 Nov 3. Analysis of PITFL injuries in rotationally unstable ankle fractures. Warner SJ1, Garner MR2, Schottel PC2, Hinds RM2, Loftus ML3, Lorich DG4.
  13. Odak S, Ahluwalia R, Unnikrishnan P, Hennessy M, Platt S. Management of Posterior Malleolar Fractures: A Systematic Review. J Foot Ankle Surg. 2016;55(1):140–5. doi: 10.1053/j.jfas.2015.04.001.[PubMed]
  14. Donatto, 2001. Donatto KC:  Ankle fractures and syndesmosis injuries.   Orthop Clin North Am   2001; 32:79.

Corresponding Author

Dr Amit Lakhani

MMM College and Hospital