ANTERIOR-TO-POSTERIOR SCREW FIXATION VS POSTEROLATERAL PLATE FOR POSTERIOR MALLEOLUS IN TRIMALLEOLAR ANKLE FRACTURES
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Abstract
Background: It has been observed that posterior malleolar fractures occur in about 7% to 44% of all ankle fractures. Posterior malleolus (PM) refers to some malleolar fractures which involve a fracture of the posterior lip of distal tibia. Research says that posterior tibial margin plays a crucial role in the maintenance of ankle stability and bearing of weight. The standard approach to treat lateral and medial malleolus fractures is selecting a surgical treatment with open reduction and internal fixation.
Objective: To compare posterolateral plate fixation with anterior-to-posterior screw fixation
Study design: A randomised comparative study
Duration and place of study: This study was conducted at Liaquat National Hospital and Medical College Karachi from June 2024 to June 2025
Methodology: This study included all the patients who were having trimalleolar ankle fracture and were admitted in the hospital. All of the participants later underwent surgical stabilisation of all 3 malleolar fragments. The participants were aged from 18 years to 60 years. Participants were divided into 2 groups by using computerised random numbering. Anterior-to-posterior screw fixation was done in group A while posterolateral plate fixation (open reduction and internal fixation) was done in group B.
Results: There were a total of 60 patients involved in this study. The participants were aged from 18 years to 60 years. All of them were divided into 2 groups of equal population (30 patients in each group). Anterior-to-posterior screw fixation was done in group A while posterolateral plate fixation (open reduction and internal fixation) was done in group B. 26.7% results were excellent in group A while 40% results were excellent in group B.
Conclusion: By fixing the posterior malleolar fracture, the stability and recovery is improved, making syndesmotic screws unnecessary. Therefore, it should be fixed in all cases regardless of size.
References
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Syed Amir Ali Shah
Consultant Orthopaedic Surgeon, Almana General Hospital KSA.
Nasir Ahmed
Assistant Professor Orthopaedic, Liaquat National Hospital and Medical College Karachi Pakistan.
Muhammad Hamayun Hameed
Associate Professor Orthopaedic, Bolan Medical Complex Hospital Quetta Pakistan.
Syed Danish Ali
Associate Professor Orthopaedic, Fazaia Ruth pfau Medical College Hospital PAF Base Faisal Karachi Pakistan.
Ghazanfar Ali Shah
Consultant Orthopaedic Surgeon, Shaheed Mohtarma Benazir Bhutto Institute Of Trauma, (SMBB-IT) / Assistant Professor, Dow University Of Health Sciences, DUHS Karachi Pakistan.
Muzaffar Rasool
Senior Registrar Orthopaedic Surgery, Teaching Hospital Noshki Balochistan Pakistan.