Clinical Outcome in a Series of Trimalleolar Fractures
Abstract:
Trimalleolar fractures, characterized by involvement of the lateral, medial, and posterior malleoli, present a complex challenge that necessitates precise surgical intervention to restore ankle stability and function. This study evaluates the outcomes of surgical management in 20 patients aged 18 to 70 years with displaced trimalleolar fractures, highlighting the increased incidence in the older population. Pre-operative planning included comprehensive assessments with basic investigations, radiological studies (X-rays in anteroposterior, lateral, and mortise views), and CT scans for evaluating posterior malleolar fragments and cases of initial ankle subluxation. Surgical techniques employed were tailored to individual fracture patterns and included plating, cannulated screws, and tension band wiring, with particular attention to the posterior malleolus. Functional outcomes were assessed using the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-Hindfoot Score, and radiological results were monitored through serial follow-up X-rays. The average follow-up duration was 12 months, during which patients demonstrated favourable functional recovery, achieving an average AOFAS score of 87.7 out of 100 at the 12-month mark. Post-operative radiological evaluations indicated successful intra-articular reduction and fixation across all cases, with progressive fracture healing observed at follow-up visits. This case series emphasizes the critical role of precise anatomical reduction, stable fixation, and a structured rehabilitation program in the successful treatment of trimalleolar fractures. Furthermore, it underscores the importance of individualized treatment plans and multidisciplinary approaches in optimizing patient outcomes.References:
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