Introduction
It has been shown that direct fixation of the posterior malleolus improves functional outcomes. Our aim was to audit the functional outcome of patients with these fractures which were fixed with an isolated posterolateral approach.
Method
A consecutive case series of patients who underwent direct fixation of the posterior malleolus using a posterolateral approach between 20/12/2012 and 23/1/2020 was identified. Fractures were classified according to Mason and Molloy classification based on preoperative CT. Type 2a and 2b fractures were included. Functional outcome was assessed using Olerud-Molander score.
Result
18 patients were included. Mean age at time of surgery was 52 years (range 20 to 75 years). 56% (n = 10) were female. Mean follow up was 18.1 months (range 4.2 months to 7.2 years). OMAS score for type 2a fractures (n = 9) was 71.1 (95% CI 65.3 to 77.0). OMAS score for type 2b fractures (n = 9) was 67.8 (95% CI 54.6 to 81.0). There was no significant difference between groups (p = 0.65).
Conclusions
Fixation of Mason and Molloy Type 2 fractures using an isolated posterolateral approach results in satisfactory functional results for the majority of patients. Further prospective comparative study is needed to identify which patients benefit most from alternative approaches.
Introduction: The distal radius has a complex kinematics for the radiocarpal and the radioulnar joints. Perfect restoration of the radial length, volar angulation and radial inclination are mandatory for complete restoration of the wrist function. Ligamentotaxis, and Open Reduction with Internal Fixation (ORIF) are the most commonly practiced two methods, to achieve the above goals in the current era of Orthopedic Practice. In this study, the functional and radiological outcomes of both Direct Reduction and Rigid fixation (ORIF with Volar Plating) and Ligamentotaxis were analyzed, to find out the best option among the two. Materials and Methods: This Prospective study was conducted in Department of Orthopedics KMCT medical college, a tertiary level health delivery institution in South India, from April 2017 to September 2018, of age group, 20 to 70 years, with Isolated closed distal end radius fracture not older than two weeks and classified as AO TYPE C -Distal end radius fracture. Those with Pregnancy, Polytrauma, other injuries in ipsilateral limb and presence of space occupying lesion at wrist were excluded from the study. Twenty patients were selected for each group, and the results were statistically analyzed using Statistical Package for Social Sciences (SPSS) 20.0 software. Results and Conclusions: In our study, on the analysis of the functional and radiological outcomes, we found there are significant advantages for volar locking plate over Ligamentotaxis, as early mobilization of the wrist and less intra/post-operative complications. Hence, it is definitely a better choice for managing Comminuted Intra Articular Distal End Radius Fractures.
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