Journal of Foot and Ankle Surgery (Asia Pacific)

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VOLUME 9 , ISSUE S1 ( August, 2022 ) > List of Articles

RESEARCH ARTICLE

Ram Janam Sulakshana Gold medal award (2021) Outcome Analysis of Posterior Plating and Lateral Plating for Lateral Malleolus Fracture

Vishnu Senthil

Keywords : American Orthopedic Foot and Ankle Society Ankle–Hindfoot Score, Bimalleolar fracture, Danis–Weber classification, Fibula fracture, Internal fixation

Citation Information : Senthil V. Ram Janam Sulakshana Gold medal award (2021) Outcome Analysis of Posterior Plating and Lateral Plating for Lateral Malleolus Fracture. J Foot Ankle Surg Asia-Pacific 2022; 9 (S1):S149-S152.

DOI: 10.5005/jp-journals-10040-1258

License: CC BY-NC 4.0

Published Online: 29-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Aim: To highlight the outcome of posterolateral and lateral approach to ankle with posterior/lateral plating of distal fibula fractures. Methodology: Twenty ankle fractures were divided into two groups. Patients were randomly allocated into two groups. In one group fibula was plated with lateral approach and another group with posterior plating. In indicated cases involving additional posterior malleolus fixation, posterior plating of fibula was done. Posterolateral/lateral approach to ankle and posterior/lateral plating of lateral malleolus was the main method used for fracture fixation. Average timing of surgery was 6 days from presentation. Minimum follow-up period was 24 months. Factors analyzed were pain, maximum walking distance, walking surfaces, wound healing, union time, and American Orthopedic Foot and Ankle Society (AOFAS) score. Results: Posterior plating showed no wound complications. Lateral plating demonstrated superficial infection in three patients and wound gaping in two patients. Posterior plating (six patients) and lateral plating (three patients) showed union within 3 months. Posterior plating (four patients) and lateral plating (six patients) demonstrated union within 3–6 months. P-value (0.062) was statistically significant but there was no significant difference clinically. Posterior plating (seven patients) and lateral plating (five patients) showed excellent functional outcome (AOFAS score > 85). Posterior plating (three patients) and lateral plating (three patients) showed good outcome (AOFAS score 70–85). In lateral group, two patients (AOFAS 55–70) showed fair outcome. p-value is statistically significant. Complications included one case of malunion in each group, three patients showed superficial infections, and two patients demonstrated wound gaping. Conclusion: Posterior approach to lateral malleolus and posterior/posterolateral plating technique allows better implant placement, lesser hardware irritation, good wound healing, practically nil wound dehiscence, and an excellent functional outcome compared to lateral approach.


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