Operative Outcome of Bimalleolar Fractures.

Background Ankle fractures are common injury occurring due to low energy trauma. Unstable ankle fractures are usually treated with operative management. Objective To find out demographic and the relationship between various clinical variables and outcome of operative treatment in ankle fractures in patient who underwent operative treatment for bimalleolar ankle fractures. Method A retrospective observational study of 32 patients who underwent operative treatment of bimalleolar ankle fracture in between January 2012 and December 2015 at Dhulikhel Hospital, Kathmandu University Hospital was performed. Skeletally mature individual of age greater than 16 years with bimalleolar ankle fractures operated within two weeks of injury were included in the study. Operating surgeon chose the type of surgery and implants required for the patient. Post operatively patients were kept in non-weight bearing for six weeks. Result The average age of the patients was 36.72 ± 19.97 years. The most common cause for the injury was twisted ankle. The mean follow up period of the patients was 20.94 ± 16.32 months. The most common fracture type was Weber B (supination external rotation injury). Most common technique for fixation for medial malleolus fracture was open reduction and modified tension band. Most of the lateral malleolus fractures were treated with open reduction and fixation with reconstruction plate. Six cases were treated with syndesmotic screws. Most of the patients had excellent AOFAS score with mean score of 90.56 ± 10.92 out of maximum 100. Average pain score was 32.81 ± 36.34 out of 40, average function score was 47.81 ± 6.05 out of 50 and average alignment score was 9.94 ± 0.35 out of 10. Conclusion The outcome of surgically treated bimalleolar ankle fractures was excellent for our patients. The fracture patterns and requirement of syndesmotic screw failed to show any significance when comparing the outcome.