Surgical treatment of ankle fractures

Abstract

Introduction: Ankles fractures represent a significant part of the trauma related to the professional activities 64%, it consists 9% of all fractures. The incidence of this fractures is about 187 fractures per 100,000 people each year, and the most of them 60-70 % are uni-maleollar, 15-20 % are bi-malleolar, and 7-12 % are tri-malleolar fractures. The aim of the study was patients evaluation with ankle fractures according to data from medical records, determination of specific parameters of ankle fracture, type of implants used and final outcomes.

Materials and methods: This work includes evaluation of 64 patients with ankle fractures, just treated surgical, 34 men and 30 women hospitalized in period of time between final of 2013-2015. According to our results the ratio male/female was 3:1 in age group between 18-30 years; while a significant increase was certified in women aged 50 years, where ratio male/female is 1:2. Our data corresponds to international literature data, with increasing number of affected women after 50 years because of the menopausal osteoporosis. In 48% of cases were determined uni-malleolar fractures, and 52% bi-malleolar, 77% of all patients were operated in first 7 days after fractures, 16% of them between 8-14 days, and 7% of patients operated more than 15 days with a period of hospitalization longer than 16 days. Distribution of the patients according to Danis-Weber classification was: 7 patients with fracture type A, 49 patients with type B fracture, and 8 patients with type C fracture. The types of implants used in surgical treatment: in 64% was applied only 1/3 tubular plate to fix lateral malleolus, 16% from the total number of patients was used wire and K-wires, in another 16% was used a combination between K-wires+screw+wire, in 2% of cases fixation was done with 1/3 tubular plate+Kwires+ wire, the remaining 2% was fixed just with K-wire.

Results: Interpretation of results was done according to the Ankle -Hindfoot Scale and showed that 8% of patients had excellent results, 60 % of patients had good results, 24,0 % of patients with rather good results and 8,0 % of patients presented poor results. The poor results were recorded in patients who addressed to orthopedist more than two weeks after the trauma.

Conclusion: Maleolar fractures have a great impact on the public health system and the whole society, because it affects patients able to work, and this indicates that the studies should focus on specific groups that are most commonly diagnosed with this type of fracture for prevention and applying appropriate treatment to ensure good functional results.