RADIOLOGICAL AND FUNCTIONAL OUTCOME OF UNSTABLE BIMALLEOLAR FRACTURES THROUGH SURGICAL TREATMENT USING BAIRD- JACKSON SCORING SYSTEM.

Dr Rohil Singh Kakkar, Dr Deepak Mehta, Dr Ankit Sisodia

Abstract


Background : Ankle fractures are one of the commonest injuries treated by orthopaedic

surgeons today. The incidence of malleolar fractures is estimated to be

125/100,000/year.[5] They are common in younger men and older women.

The goals of surgical treatment must include anatomic reduction of articular surfaces, restoring metaphyseal stability , preserving blood supply and allowing early motion.

 

 

 

Materials and Methods : A prospective study was conducted in the Department of Orthopaedic Surgery, Grant Medical Foundation-Ruby Hall Clinic,India on 26 cases of  unstable bimalleolar fractures of ankle joint in patients between the age of 18-60 years who underwent surgical treatment with Open Reduction and Internal Fixation with one third tubular locking plate for lateral malleolar fracture and CC/Malleolar screw(s) for medial malleolar fracture between December 2017- March 2019 . These patients were followed for 12 months (minimum for 6 months) and evaluated based on union rate through xray radiograph, any complications (infections, mal/nonunion, stiffness) and functionally by Baird and Jackson ankle scoring system.

 

 

 

Results: In our study, majority of the patients were male (65.3%), most

of the patients were in the age group of 21- 48 years with mean

age of 34.5 years. Majority of the patients sustained these

injuries following RTA(69.2%). According to Lauge-Hansen classification system, 15 (57.69%) cases had supination external rotation type of injury, 6 (23.07%) cases had pronation external rotation type of injury, 4 (15.38%) cases had supination adduction type of injury and 1 (3.84%) cases had pronation abduction mechanism of injury pattern.3 patients had associated syndesmotic injury. Radiological union  was seen at 8 weeks in 4 (15.38%) cases, 10 weeks in 13 (50%) cases, 12 weeks in 5 (19.23%) cases, 14 weeks in 3 (11.53%) cases and 16 weeks in 1 (3.84%) cases. Out of  26 cases, two (7.69%) cases had superficial infection which resolved completely with oral antibiotics and one (3.84%) case had ankle joint stiffness.There were no cases of nonunion or malunion in the present study.As per the Baird Jackson scoring system, 15 (57.7%) cases had excellent results, 7 (26.9%) had good, 2 (7.69%) had fair and 2 (7.69%) of the cases had poor results respectively.

 

 

 

 

 

 

Conclusion : Open reduction and internal fixation should be the treatment of choice for the unstable bimalleolar fractures, as these surgical methods restores the anatomy, biomechanics and contact loading characteristics of the ankle joint.

 


Keywords


Bimalleolar Fracture, Ankle Joint ORIF , Lauge-Hansen, Weber, Baird Jackson.

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