Chinese Journal of Tissue Engineering Research ›› 2010, Vol. 14 ›› Issue (26): 4907-4910.doi: 10.3969/j.issn.1673-8225.2010.26.039

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Internal fixation modes and materials of metal implants for displaced supination-eversion ankle fractures in elderly patients

Li Jun, Chai Wei-bing, Lu Hong-zhang, Liu Zhen-ning, Liu Xian-yi, Zhu Tian-yue   

  1. Department of Orthopaedics, Peking University First Hospital, Beijing  100034, China
  • Online:2010-06-25 Published:2010-06-25
  • About author:Li Jun, Doctor, Associate chief physician, Department of Orthopaedics, Peking University First Hospital, Beijing 100034, China lijunsurgeon@medmail.com.cn

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Abstract:

BACKGROUND: Stable anatomical reconstruction of the joint surface in displaced supination-eversion ankle fractures is essential to successful recovery. It is difficult to fix the osteoporosis ankle fracture in the elderly patients, thus, complications often happen after open reduction and internal fixation.

OBJECTIVE: To explore the surgical treatment internal fixation selection for displaced supination-eversion ankle fracture in elderly patients. 

METHODS: Totally 128 elderly patients with supination-eversion ankle fractures were treated by open reduction and internal fixation. Twenty-nine cases had only lateral malleolus fracture, 52 had bimalleolar fracture and 47 had trimalleolar fracture. A total of 122 patients were treated with a conventional lateral plate (98 one-third tubular plates and 24 locking-plates), and six patients were treated with an antiglide plate. Posterior malleolus fractures with defects bigger than 1/4 of the joint surface were reduced and fixed with compression screw of 3.5 mm through posterolateral approach. Their functional results were evaluated according to the Olerud and Molander system and the bone healing was evaluated by X-ray film. 

RESULTS AND CONCLUSION: All patients were followed-up for 12-25 months. The fractures were healed in all cases. Five cases (4%) suffered from delayed wound union, including three patients treated with locking plates and two patients with one-third tubular plates. The clinical results were satisfactory, with the excellent and good ratio of ankle score being 91%. Thirty-one patients treated with lateral plates underwent implants removal after union, including 19 cases with tubular plates and 12 cases with locking plates, there was significant difference (P < 0.05). Cold-welding occurred in two cases (17%) treated with locking plates during the removal of implants. One case suffered from peroneal tendonitis after antiglide plate fixation. Exact reduction, stable internal fixation and active postoperative rehabilitation can help the joint recover to normal function in elderly patients with displaced supination-eversion ankle fractures.

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