![]() Various fixation strategies for lateral malleolar fractures have been described lag screws with neutralization plating, intramedullary devices, antiglide plating, and bridge plating in cases of comminution are some of the most commonly used techniques in practice today. Osteosynthesis techniques for bimalleolar ankle fractures are relatively well established, but operative planning can be dependent on fracture pattern, surgeon preference, and patient comorbidities. Although operative guidelines are fairly well established, postoperative weight-bearing protocols have not been well studied, and controversy exists regarding optimal time to weight bearing in this population. The majority of ankle fractures occur secondary to ground-level falls, but irrespective of the injury mechanism, fracture characteristics often dictate the need for operative stabilization. ![]() The incidence is likely to increase as the average age of the population rises, as does the amount of participation in sports-related activities. The incidence of ankle fractures is approximately 71-187 per 100,000 people per year and is one of the most common injuries treated by orthopedic surgeons. This study suggests that EWB at three weeks postoperatively does not increase markers of radiographic failure compared to six weeks of non-weight bearing (NWB), which has been regarded as the gold standard of treatment to allow for healing this may represent an improvement to rehabilitation protocols after bimalleolar ankle ORIF of unstable ankle fractures. No differences in medial clear space were detected at any postoperative interval between groups (p>0.1 at all time intervals). The EWB group on average began to weight bear at 3.1 + 1.4 weeks postoperatively, whereas the LWB group began at 7.2 + 2.1 weeks postoperatively (p0.1 at all time intervals) were not notably different between groups. There were no significant demographic differences between groups. There were 38 patients (40%) in the EWB group and 57 patients (60%) comprising the LWB cohort. Postoperatively, patients were evaluated at regular intervals for fracture union, signs of implant failure, and evidence of medial clear space widening radiographically. This study seeks to clarify postoperative fracture union rates, rates of hardware loosening or failure, and radiographic medial clear space changes when comparing EWB to late weight bearing (LWB) following open reduction and internal fixation (ORIF).Ī total of 95 patients with either bimalleolar (66%) or bimalleolar equivalent (34%) fractures who underwent ORIF were retrospectively reviewed. Weight bearing was allowed at three weeks in the EWB group and when signs of radiographic union were noted in the LWB group. Although operative indications and subsequent stabilization of these fractures have not significantly changed, postoperative protocols remain highly variable. Effects of early weight bearing (EWB) on fracture characteristics in operatively stabilized bimalleolar and bimalleolar equivalent ankle fractures remain poorly publicized. The other option involves fitting plates and screws along the back of the tibia.Ankle fractures are common orthopedic injuries. One option involves inserting screws that run from the front to the back of the ankle or the other way around. There are different options for surgery on this malleolus. ![]() ![]() Bone grafting can reduce the risk of arthritis.Ī surgeon can fix bone fragments using screws, plates, and wiring techniques. When this occurs, a surgeon may need to do a bone graft, which acts as a frame on which new bone can grow. Sometimes, a medial malleolus fracture may result in impaction of the ankle joint, which is when force drives one bone into another. Surgery on the medial malleoli can improve the chances of successful healing and allow the person to resume normal movement sooner. The surgeon will then attach screws and metals plates to the outer surface of the bone to hold them in place.įor some people, the surgeon may insert a screw or rod inside the bone to keep the bone fragments together as they heal. Share on Pinterest A person often requires intensive surgery after a trimalleolar fracture.Īs trimalleolar fractures are often unstable, a doctor will usually recommend surgery as treatment.Įach fracture will require a specific repair procedure during the surgery.įirstly, the surgeon will realign the bone fragments, returning them to their original position. ![]()
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