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A retrospective study of posterior malleolus fractures

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Abstract

Purpose

In this retrospective study, we evaluated the treatment effect of ankle joint fracture surgery involving the posterior malleolus, and discuss relevant factors influencing the occurrence of traumatic arthritis of the ankle joint.

Methods

A total of 102 cases of ankle joint fractures involving the posterior malleolus in five large-scale skeletal trauma centres in China, from January 2000 to July 2009, were retrospectively analysed in terms of surgical treatment and complete follow-up. Ankle joint mobility, posterior malleolus fragment size, articular surface evenness, Ankle-Hindfoot Scale of the American Orthopedic Foot and Ankle Society (AOFAS) score, and imaging scale score for arthritis were recorded. The degree of fracture pain during rest, active movement, and weight-bearing walking, and satisfaction with treatment were evaluated using a visual analogue scale (VAS).

Results

The average AOFAS score was 95.9, excellence rate was 92.2 %, and average VAS scores for degree of fracture pain during rest, active movement, and weight-bearing walking were 0.15, 0.31, and 0.68, respectively. Thirty-six cases showed arthritic manifestations. Ankle joint mobility along all directions on the injured side was lower than that on the unaffected side. There was no obvious difference in treatment effect between the fixed and unfixed posterior malleolus fragment groups for all and for fragment size of <25 %; between fixing the posterior malleolus fragment from front to back or from back to front; or between elderly patients (≥60 years old) and young patients (<60 years old). There was a distinct difference in the treatment effect between articular surface evenness and unevenness for all and for fragment size of ≥25 %.

Conclusions

For all 102 cases of ankle joint fracture involving the posterior malleolus, the treatment effect was satisfactory. Restoration of an even articular surface, especially when fragment size ≥25 %, should be attempted during treatment.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopaedic Trauma, Peking University People’s Hospital, Beijing, 100044, China

    Hai-lin Xu, Xuan Li, Dian-ying Zhang, Zhong-guo Fu, Tian-bing Wang, Pei-xun Zhang & Bao-guo Jiang

  2. Department of Orthopaedics, Xuan Wu Hospital, Capital Medical University, Beijing, 100053, China

    Hui-liang Shen

  3. Department of Orthopaedics, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, China

    Gang Wang

  4. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China

    Guang-lin Wang

  5. Department of Orthopaedics, Jishuitan Hospital, Peking University, Beijing, 100035, China

    Xin-bao Wu

Authors
  1. Hai-lin Xu
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  2. Xuan Li
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  3. Dian-ying Zhang
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  4. Zhong-guo Fu
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  5. Tian-bing Wang
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  6. Pei-xun Zhang
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  7. Bao-guo Jiang
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  8. Hui-liang Shen
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  9. Gang Wang
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  10. Guang-lin Wang
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  11. Xin-bao Wu
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Corresponding authors

Correspondence to Bao-guo Jiang or Hui-liang Shen.

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Xu, Hl., Li, X., Zhang, Dy. et al. A retrospective study of posterior malleolus fractures. International Orthopaedics (SICOT) 36, 1929–1936 (2012). https://doi.org/10.1007/s00264-012-1591-9

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  • DOI: https://doi.org/10.1007/s00264-012-1591-9

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