Pattern of Bimalleolar Ankle Fractures
To determine the pattern and outcome of bimalleolar ankle fractures .
Methods: In this prospective observational study of 72 patients with bimalleolar ankle fractures were included and were followed up for 12 weeks. The American Orthopaedic Foot and Ankle Score (AOFAS) and Visual Analog Pain Scale (VAS) were used to assess short term outcomes as at 12 weeks. The main outcome measures were pain, functional capacity and alignment.
Results: The patients’ age ranged from 19 to 63 mean 36.4 ±10.4 years. The male to female ratio was 3:2. Falls caused 50% of the fractures, motor vehicle accidents 36.1% and motor cycle accidents 13.9%. Closed fractures accounted for 63.9% of the cases. The most common fractures based on the Weber classification were B and C which occurred in 33 (45.8%) and 31 (43.1%) patients, respectively. At 3 months, the mean AOFAS was 78.2. The VAS between 1 and 3 was 43.1%. Twenty eight patients (38.8%) had no pain. There was no difference in AOFAS and VAS between operative and non operative, open or closed Weber B fracture outcomes. The Weber C fractures managed operatively had a significantly lower AOFAS, 63 compared to non-operative cases who scored 84.3. Medial clear space greater than 4mm was associated with a poor outcome.
Conclusion: Patients mostly were young. Delay in definitive treatment of up to a week post-fracture does not seem to adversely affect the outcome. The main determinant of good outcome was the medial clear space that was less than 4mm
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