Negative prognostic factors in surgical treatment for trimalleolar fractures
- 49 Downloads
Trimalleolar fractures are a common injury of the ankle that require surgical treatment to obtain an anatomic reduction of both malleoli and stabilization of the syndesmosis. This study aims to report the outcomes of surgical treatment for trimalleolar fractures, identifying the risk factors determining a worse result.
Materials and methods
Between January 2013 and December 2016, 48 patients with trimalleolar fracture treated with open reduction and internal fixation were retrospectively analyzed. The mean age was 44.69 years, and average body mass index (BMI) was 29.04. According to the Danis–Weber classification, 30 (62.5%) fractures were type B and 18 (37.5%) were type C. Clinical and radiographic evaluations at 3, 6, and 12 months were assessed. The functional results of Visual Analogue Staircases and Olerud–Molander (O&M) ankle score were reported.
No significant difference was found among the size of the PM in patients with and without ankle dislocation (p = 0.364). Therefore, there is no correlation between the size of the posterior fragment and the ankle dislocation and the size of the posterior malleolus and syndesmosis stability (p = 0.328). Age over 61 years, BMI > 40, ASA > 1, type C fracture, and fracture dislocation were considered as negative prognostic fractures.
Surgical treatment for trimalleolar fractures needs accurate preoperative planning. Age over 61 years, BMI > 40, ASA > 1, type C fracture, and fracture dislocation were considered as negative prognostic fractures.
KeywordsTrimalleolar fractures Posterior malleolus Outcome Open reduction Internal fixation
This study was funded by the authors.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 10.Nelson MC, Jensen NK (1940) The treatment of trimalleolar fractures of the ankle. Surg Gynecol Obstet 71:509–514Google Scholar
- 13.Danis R (1949) Les fractures malleolaires. In: Danis R (ed) Theorie et Pratique de l’Osteosynthese. Masson, Paris, pp 133–165Google Scholar
- 22.Hartford JM, Gorczyca JT, McNamara JL, Mayor MB (1995) Tibiotalar contact area. Contribution of posterior malleolus and deltoid ligament. Clin Orthop Relat Res 320:182–187Google Scholar
- 23.Cho BK, Choi SM, Shin YD (2018) Prognostic factors for intermediate-term clinical outcomes following Bosworth fractures of the ankle joint. Foot Ankle Surg (Epub ahead of print)Google Scholar
- 25.Heim UF (1989) Trimalleolar fractures: late results after fixation of the posterior fragment. Orthopedics 12(8):1053–1059Google Scholar