No abstract

Background: Malleolar injuries are the most common significant lower extremity fractures. These injuries gain importance, because the whole body weight is transmitted through the ankle, and locomotion depends on the stability of the ankle. Open reduction and internal fixation have become the mainstay of treatment for most of the unstable bimalleolar fractures, as these operative methods restores the anatomy, biomechanics and contact loading characteristics of the ankle. Objectives: To study the functional outcome of surgically managed bimalleolar fractures of ankle in adults. Methods: A prospective study of 30 cases of bimalleolar fractures of ankle in adults, managed surgically by various techniques in During the period from December 2014 to May 2016 were studied, satisfying the inclusion and exclusion criteria were studied. The functional outcome was evaluated using the Biard and Jackson's ankle scoring system. Results: In our study we achieved 86.6% excellent to good results, 6.6% fair results, 6.6% poor results. The results were comparable to other studies. Interpretation & Conclusion:The operative results were satisfactory in 86.6% cases, with good to excellent functional outcome. Excellent results are obtained with stable fixation of fracture. Cancellous screws or malleolar screws are far better in internal fixation of medial malleolus compared to Kirschnerwire fixation and lateral plating was the best for fibular fractures. Good functional results are obtained by surgical management of bimalleolar ankle fractures. Early weight bearing and mobilisation is achieved in these patients. Anatomical reduction with restoration of the articular congruence is essential in all intra articular fractures, more so, if a weight bearing joint like ankle is involved. Open reduction and internal fixation restores the articular congruity of the ankle joint. TBW done for many PER and PA injuries showed promising results comparable to that with screw fixation and also lesser reports of skin irritation at the wound site. It is the method preferred for small transverse fragments and osteoporotic bones of both malleoli especially in the elderly.